Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2751 | PR |
Y | 1223P0700X | Prosthodontist | 2751 | PR |
NPI | 1215089842 |
---|---|
Provider Name | Dr. Jose A. Lopez-Calero |
First Address | Carolina, PR 00984-1893 |
Second Address | Carolina, PR 00987 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 12/02/2016 |