Provider Demographics
NPI:1316912272
Name:LIPTON, LAWRENCE I (DMD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:I
Last Name:LIPTON
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 1:1817 BLACK ROCK TPKE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3546
Mailing Address - Country:US
Mailing Address - Phone:203-336-5544
Mailing Address - Fax:203-336-5544
Practice Address - Street 1:1817 BLACK ROCK TPKE
Practice Address - Street 2:SUITE #3
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3546
Practice Address - Country:US
Practice Address - Phone:203-336-5544
Practice Address - Fax:203-336-5544
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT45961223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry