Provider Demographics
NPI:1043448418
Name:LOPEZ, ANIBAL (DDS)
Entity type:Individual
Prefix:
First Name:ANIBAL
Middle Name:
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 1:220 W FRANCIS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6300
Mailing Address - Country:US
Mailing Address - Phone:509-466-1200
Mailing Address - Fax:509-466-1647
Practice Address - Street 1:220 W FRANCIS AVE STE A
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6300
Practice Address - Country:US
Practice Address - Phone:509-466-1200
Practice Address - Fax:509-466-1647
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60091762122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist