| NPI | 1194095596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM E LIPPISCH Owner 772-223-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL BL1797058) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |