Provider Demographics
NPI:1023421104
Name:LOPEZ, ARNALDO ANDRE (DDS)
Entity type:Individual
Prefix:DR
First Name:ARNALDO
Middle Name:ANDRE
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5966 S DIXIE HWY
Mailing Address - Street 2:SUITE 312
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5170
Mailing Address - Country:US
Mailing Address - Phone:305-239-9273
Mailing Address - Fax:305-239-9274
Practice Address - Street 1:5966 S DIXIE HWY
Practice Address - Street 2:SUITE 312
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5170
Practice Address - Country:US
Practice Address - Phone:305-239-9273
Practice Address - Fax:305-239-9274
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN206491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice