Provider Demographics
NPI:1376194639
Name:SNOW NAKANO & LOPEZ PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:SNOW NAKANO & LOPEZ PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEONOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PINEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-450-0116
Mailing Address - Street 1:868 AUTO CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4691
Mailing Address - Country:US
Mailing Address - Phone:661-450-0116
Mailing Address - Fax:
Practice Address - Street 1:868 AUTO CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4691
Practice Address - Country:US
Practice Address - Phone:661-450-0116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty