| Eustorgio a Lopez LLC | |
|
1548 Nw 208th Way Pembroke Pines FL 33029-2306 | |
| (786) 375-1449 | |
| (954) 337-0356 |
| Full Name | Eustorgio a Lopez LLC |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1548 Nw 208th Way, Pembroke Pines, Florida |
| Authorized Official Name and Position | Eustorgio a Lopez (PRESIDENT) |
| Authorized Official Contact | 7863751449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eustorgio a Lopez LLC 1548 Nw 208th Way Pembroke Pines FL 33029-2306 Ph: (786) 375-1449 | Eustorgio a Lopez LLC 1548 Nw 208th Way Pembroke Pines FL 33029-2306 Ph: (786) 375-1449 |
| NPI Number | 1023362811 |
|---|---|
| Provider Enumeration Date | 11/01/2012 |
| Last Update Date | 11/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023362811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | ME74506 (Florida) | Primary |
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