Provider Demographics
NPI:1104036839
Name:LIPKIN, MARC F (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:F
Last Name:LIPKIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 EAST BROAD ST
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SOUDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18964
Mailing Address - Country:US
Mailing Address - Phone:215-723-5531
Mailing Address - Fax:215-721-9119
Practice Address - Street 1:601 EAST BROAD ST
Practice Address - Street 2:SUITE #200
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964
Practice Address - Country:US
Practice Address - Phone:215-723-5531
Practice Address - Fax:215-721-9119
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021793L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist