Provider Demographics
NPI:1346400025
Name:LOPEZ FRANCO, GLORIA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:E
Last Name:LOPEZ FRANCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SNELLING AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6744
Mailing Address - Country:US
Mailing Address - Phone:651-645-6111
Mailing Address - Fax:651-645-6014
Practice Address - Street 1:120 SNELLING AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6744
Practice Address - Country:US
Practice Address - Phone:651-645-6111
Practice Address - Fax:651-645-6014
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND12522122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN321818000Medicaid