Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH19403 | FL |
NPI | 1053833210 |
---|---|
Provider Name | Arlene Lopez |
First Address | Lantana, FL 33462-1459 |
Second Address | Lantana, FL 33462-1459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2017 |
Last Update Date | 10/07/2017 |