Individual
JOHANNA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7510 GARNERS FERRY RD, COLUMBIA, SC 29209-5801
(786) 538-5248
Mailing address
102 WAHOO CIR, IRMO, SC 29063-9817
(786) 538-5248
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11280
SC
122300000X
Dentist
Primary
DGD11280
SC
Other
Enumeration date
11/06/2025
Last updated
03/12/2026
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