Provider Demographics
NPI:1073630216
Name:LIPSCOMB, MARSHALL SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:SCOTT
Last Name:LIPSCOMB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2446 LILLIAN MILLER PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-2903
Mailing Address - Country:US
Mailing Address - Phone:940-387-9422
Mailing Address - Fax:940-484-2634
Practice Address - Street 1:2446 LILLIAN MILLER PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-2903
Practice Address - Country:US
Practice Address - Phone:940-387-9422
Practice Address - Fax:940-484-2634
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice