Provider Demographics
NPI:1811544893
Name:VICTOR D LOPEZ DEL AGUILA DDS INC
Entity Type:Organization
Organization Name:VICTOR D LOPEZ DEL AGUILA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LOPEZ DEL AGUILA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-822-9960
Mailing Address - Street 1:2717 PARKVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933-6250
Mailing Address - Country:US
Mailing Address - Phone:213-822-9960
Mailing Address - Fax:
Practice Address - Street 1:224 SAN JOSE ST STE 4
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3931
Practice Address - Country:US
Practice Address - Phone:831-202-0440
Practice Address - Fax:831-202-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental