Provider Demographics
NPI:1609237056
Name:ARROYO-LOURENCO DENTAL CORPORATION
Entity Type:Organization
Organization Name:ARROYO-LOURENCO DENTAL CORPORATION
Other - Org Name:LATIN FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AURY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOURENCO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-373-1300
Mailing Address - Street 1:81800 DR CARREON BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-0608
Mailing Address - Country:US
Mailing Address - Phone:760-972-4705
Mailing Address - Fax:760-972-4276
Practice Address - Street 1:81800 DR CARREON BLVD STE D
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-0608
Practice Address - Country:US
Practice Address - Phone:760-972-4705
Practice Address - Fax:760-972-4276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56298122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty