Individual
DR. MARISA ANN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
11835 SOUTHMORE DR STE 201, CHARLOTTE, NC 28277-4820
(973) 941-2614
Mailing address
98 PANCAKE HOLLOW DR, WAYNE, NJ 07470-3205
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
0581951
NY
1223P0221X
Pediatric Dentistry
Primary
12699
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/12/2013
Last updated
02/28/2023
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