Organization
JUAN R LOPEZ DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLA D SHANNON (BUSINESS COORDINATOR)
(580) 536-9647
Entity
Organization
Contact information
Practice address
6941 W GORE BLVD, LAWTON, OK 73505-5311
(580) 536-9647
(580) 536-4075
Mailing address
6941 W GORE BLVD, LAWTON, OK 73505-5311
(580) 536-9647
(580) 536-4075
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5022
OK
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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