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General NPI Number Information
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NPI Number | 1194095596
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Entity Type | Organization
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Legal Business Name | WILLIAM E. LIPPSICH, D.M.D., P.A.
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 841 E OCEAN BLVD
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City | STUART
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State | FL
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Zip | 34994-2427
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Country | US
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Telephone | 772-223-0600
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Fax | 772-223-0617
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Provider Business Mailing Address
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Address Line | 841 E OCEAN BLVD
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City | STUART
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State | FL
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Zip | 34994-2427
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Country | US
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Telephone | 772-223-0600
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Fax | 772-223-0617
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM E LIPPISCH
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Credential | D.M.D.,P.A.
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Telephone | 772-223-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | BL1797058
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License Number State | FL
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