Individual
BRYAN LOPEZ GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2845 VIRGINIA AVE, COLLINSVILLE, VA 24078-2247
(276) 647-1494
Mailing address
349 LAUREL WOODS DR, DANVILLE, VA 24540-5205
(706) 313-9122
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418961
VA
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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