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Individual

DR. MITCHELL JAY LIPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2650 OCEAN PARKWAY, SUITE 1M, BKLYN, NY 11235
(718) 769-9293
(718) 891-3718
Mailing address
2650 OCEAN PARKWAY, SUITE 1M, BKLYN, NY 11235
(718) 769-9293
(718) 891-3718

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0395021
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01059970
NY
Enumeration date
11/24/2006
Last updated
07/08/2007
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