Provider Demographics
NPI:1194021949
Name:AURY ARROYO LOURENCO, DDS, INC.
Entity Type:Organization
Organization Name:AURY ARROYO LOURENCO, DDS, INC.
Other - Org Name:LATIN DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:AURY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARROYO LOURENCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-994-6080
Mailing Address - Street 1:8111 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4862
Mailing Address - Country:US
Mailing Address - Phone:818-994-6080
Mailing Address - Fax:818-994-6086
Practice Address - Street 1:8111 VAN NUYS BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4862
Practice Address - Country:US
Practice Address - Phone:818-994-6080
Practice Address - Fax:818-994-6086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty