Provider Demographics
NPI:1568444560
Name:LOPEZ ALVAREZ, YASMIN A (DMD)
Entity Type:Individual
Prefix:MRS
First Name:YASMIN
Middle Name:A
Last Name:LOPEZ ALVAREZ
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:PO BOX 4752
Mailing Address - Street 2:VALLE ARRIBA HEIGHTS
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-4752
Mailing Address - Country:US
Mailing Address - Phone:787-251-5949
Mailing Address - Fax:787-251-5949
Practice Address - Street 1:LAS FUENTES SHOPPING MALL
Practice Address - Street 2:#19
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-251-5949
Practice Address - Fax:787-251-5949
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice