MEDICARE: DR. FRANK LIPNISKI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS020268L	PA

General Provider Information

NPI Number	:	1982729356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK LIPNISKI DDS

Provider Business Mailing Address
First Line	:	9 WHITECHAPEL DR
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-3315
Country	:	US
Telephone Number	:	856-235-4436
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 HARRISON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-5932
Country	:	US
Telephone Number	:	215-743-1634
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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