Provider Demographics
NPI:1710010707
Name:AGARD & LIPKER DENTAL, S.C.
Entity Type:Organization
Organization Name:AGARD & LIPKER DENTAL, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:AGARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-755-1082
Mailing Address - Street 1:1336 CRESTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-1119
Mailing Address - Country:US
Mailing Address - Phone:608-755-1082
Mailing Address - Fax:608-754-0192
Practice Address - Street 1:1336 CRESTON PARK DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-1119
Practice Address - Country:US
Practice Address - Phone:608-755-1082
Practice Address - Fax:608-754-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty