Provider Demographics
NPI:1710532189
Name:LOPEZ, ALEX GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:GEORGE
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 64TH ST SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-7333
Mailing Address - Country:US
Mailing Address - Phone:239-438-0733
Mailing Address - Fax:
Practice Address - Street 1:1008 GOODLETTE RD STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5406
Practice Address - Country:US
Practice Address - Phone:239-307-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN244551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice