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General NPI Number Information
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NPI Number | 1205045804
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Entity Type | Individual
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Provider Name | IRENE F LIPETSKER DMD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1247A BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-5202
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Country | US
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Telephone | 617-566-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 52 STONY BRAE RD
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City | NEWTON
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State | MA
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Zip | 02461-1727
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Country | US
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Telephone | 617-332-7093
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18213
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License Number State | MA
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