Organization
WALTER LEE TIPPIN,DDS, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER LEE TIPPIN D.D.S, P.C (GENERAL DENTIST)
(915) 255-4200
Entity
Organization
Contact information
Practice address
3021 TRAWOOD DR, SUITE 1B, EL PASO, TX 79936-4330
(915) 855-4200
(915) 855-4633
Mailing address
3021 TRAWOOD DR, SUITE 1B, EL PASO, TX 79936-4330
(915) 855-4200
(915) 855-4633
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091037401
—
TX
01
—
600826
UNITED CONCORDIA TRICARE
PA
01
—
B1341201
DELTA DENTAL
CA
Enumeration date
10/30/2008
Last updated
10/30/2008
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