Provider Demographics
NPI:1649454802
Name:MANLAPAZ, LOVELY C (DDS)
Entity type:Individual
Prefix:
First Name:LOVELY
Middle Name:C
Last Name:MANLAPAZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 CREPE MYRTLE DR
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-2650
Mailing Address - Country:US
Mailing Address - Phone:650-766-1777
Mailing Address - Fax:
Practice Address - Street 1:844 WILLOW AVENUE
Practice Address - Street 2:SUITE - A6
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547
Practice Address - Country:US
Practice Address - Phone:510-590-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA536261223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice