Individual
JACK I. LIPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1754 S FORT APACHE RD # 1, CAMP VERDE, AZ 86322-6909
(480) 329-6684
Mailing address
1754 S FORT APACHE RD # 1, CAMP VERDE, AZ 86322-6909
(480) 329-6684
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60861
CA
1223G0001X
General Practice Dentistry
Primary
D4375
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60861
DENTAL LICENSE
CA
Enumeration date
06/28/2006
Last updated
09/21/2018
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