Provider Demographics
NPI:1730751959
Name:LOPEZ URAN, FLOYD
Entity type:Individual
Prefix:
First Name:FLOYD
Middle Name:
Last Name:LOPEZ URAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18334 PATRIOT WAY
Mailing Address - Street 2:
Mailing Address - City:WEST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02817-6022
Mailing Address - Country:US
Mailing Address - Phone:954-471-6643
Mailing Address - Fax:
Practice Address - Street 1:121 SANDY BOTTOM RD
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-5865
Practice Address - Country:US
Practice Address - Phone:401-822-3352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN03556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist