Provider Demographics
NPI:1942632617
Name:LOPEZ, REINIER (DMD)
Entity Type:Individual
Prefix:DR
First Name:REINIER
Middle Name:
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 1:2485 SW 9TH ST
Mailing Address - Street 2:APT # 1
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4864
Mailing Address - Country:US
Mailing Address - Phone:786-302-7072
Mailing Address - Fax:
Practice Address - Street 1:750 NW 20TH ST
Practice Address - Street 2:BUILDING G:110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4618
Practice Address - Country:US
Practice Address - Phone:305-324-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 20324122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist