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General NPI Number Information
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NPI Number | 1891875019
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Entity Type | Organization
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Legal Business Name | LAWRENCEVILLE ORAL & MAXILLOFACIAL SURGERY
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3100 PRINCETON PIKE BLDG 4 SUITE F
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2300
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Country | US
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Telephone | 609-896-2999
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Fax | 609-896-0701
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Provider Business Mailing Address
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Address Line | 3100 PRINCETON PIKE BLDG 4 SUITE F
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2300
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Country | US
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Telephone | 609-896-2999
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Fax | 609-896-0701
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. WILLIAM PERSON HIPPLE
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Credential | D.D.S.
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Telephone | 609-896-2999
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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 | D106545
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License Number State | NJ
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