Individual
ANGEL RAY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
151 DREXLER CIR, ELIZABETHTOWN, KY 42701-7843
(270) 942-1277
(859) 554-0278
Mailing address
151 DREXLER CIR, ELIZABETHTOWN, KY 42701-7843
(270) 942-1277
(859) 554-0278
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.026059
OH
1223G0001X
General Practice Dentistry
30.026059
OH
1223P0221X
Pediatric Dentistry
Primary
10616
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2019
Last updated
06/08/2021
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