Provider Demographics
NPI:1366758914
Name:TRACY LIPSON-BECK, D.D.S., L.L.C.
Entity type:Organization
Organization Name:TRACY LIPSON-BECK, D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSON-BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-388-7270
Mailing Address - Street 1:6 MORNINGSIDE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-1108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 MORNINGSIDE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-1108
Practice Address - Country:US
Practice Address - Phone:732-388-7270
Practice Address - Fax:732-396-7124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023040001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty