Provider Demographics
NPI:1275642894
Name:LIPSCHULTZ, JOSHUA GORDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:GORDON
Last Name:LIPSCHULTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:411 MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1080
Mailing Address - Country:US
Mailing Address - Phone:651-224-4969
Mailing Address - Fax:651-223-8047
Practice Address - Street 1:411 MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1080
Practice Address - Country:US
Practice Address - Phone:651-224-4969
Practice Address - Fax:651-223-8047
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2013-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MND122401223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry