Provider Demographics
NPI:1558841890
Name:LOPEZ GARCIA, CATHERINE ANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANNE
Last Name:LOPEZ GARCIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16008 NW 87TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1427
Mailing Address - Country:US
Mailing Address - Phone:305-788-5491
Mailing Address - Fax:
Practice Address - Street 1:1945 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-5203
Practice Address - Country:US
Practice Address - Phone:954-473-9161
Practice Address - Fax:954-473-9160
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist