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General NPI Number Information
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NPI Number | 1710010707
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Entity Type | Organization
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Legal Business Name | AGARD & LIPKER DENTAL, S.C.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1336 CRESTON PARK DR
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City | JANESVILLE
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State | WI
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Zip | 53545-1119
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Country | US
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Telephone | 608-755-1082
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Fax | 608-754-0192
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Provider Business Mailing Address
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Address Line | 1336 CRESTON PARK DR
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City | JANESVILLE
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State | WI
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Zip | 53545-1119
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Country | US
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Telephone | 608-755-1082
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Fax | 608-754-0192
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS E. AGARD
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Credential | DDS
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Telephone | 608-755-1082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2320
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License Number State | WI
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