Provider Demographics
NPI:1295783918
Name:LOPEZ DEL VALLE, LYDIA MARIA (DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:MARIA
Last Name:LOPEZ DEL VALLE
Suffix:
Gender:F
Credentials:DMD, MPH
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Mailing Address - Street 1:I5 CALLE REINA SOFIA
Mailing Address - Street 2:MANSIONES REALES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5243
Mailing Address - Country:US
Mailing Address - Phone:787-720-3740
Mailing Address - Fax:787-763-4868
Practice Address - Street 1:A2 AVE APOLO
Practice Address - Street 2:URBANIZACION APOLO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5032
Practice Address - Country:US
Practice Address - Phone:787-720-3740
Practice Address - Fax:787-763-4868
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR1223122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist