| Carmen Denise Maroon Lopez | |
|
2648 Main St Ste A Chula Vista CA 91911-4664 | |
| (619) 423-5200 | |
| (619) 423-2706 |
| Full Name | Carmen Denise Maroon Lopez |
|---|---|
| Speciality | Dentist |
| Location | 2648 Main St Ste A, Chula Vista, California |
| Authorized Official Name and Position | Carmen Denise Maroon-lopez (PRESIDENT) |
| Authorized Official Contact | 6194235200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carmen Denise Maroon Lopez 2648 Main St Ste A Chula Vista CA 91911-4664 Ph: (619) 423-5200 | Carmen Denise Maroon Lopez 2648 Main St Ste A Chula Vista CA 91911-4664 Ph: (619) 423-5200 |
| NPI Number | 1225415862 |
|---|---|
| Provider Enumeration Date | 05/04/2015 |
| Last Update Date | 05/04/2015 |
| Medicare PECOS PAC ID | 7012376189 |
|---|---|
| Medicare Enrollment ID | O20230707000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225415862 | NPI | - | NPPES |
| 1316186562 | Other | CA | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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