Provider Demographics
NPI:1336291137
Name:LOPEZ, ALFRED L JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:L
Last Name:LOPEZ
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:10409 MONTGOMERY PARKWAY NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111
Mailing Address - Country:US
Mailing Address - Phone:505-717-2928
Mailing Address - Fax:505-717-2897
Practice Address - Street 1:10409 MONTGOMERY PARKWAY NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111
Practice Address - Country:US
Practice Address - Phone:505-717-2928
Practice Address - Fax:505-717-2897
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2020-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM1647122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist