Provider Demographics
NPI:1639528011
Name:SOTO LOPEZ, ADRIAN E (DDS)
Entity type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:E
Last Name:SOTO LOPEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ADRIAN
Other - Middle Name:E
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:6132 CAROLINA BEACH RD STE 6
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2759
Mailing Address - Country:US
Mailing Address - Phone:910-392-9101
Mailing Address - Fax:
Practice Address - Street 1:6132 CAROLINA BEACH RD STE 6
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2759
Practice Address - Country:US
Practice Address - Phone:910-392-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC115311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice