| Gary A. Lewis, D.m.d., P.a. | |
|
107 Drennon Dr Jesup GA 31545-0011 | |
| (912) 427-7072 | |
| (912) 427-9350 |
| Full Name | Gary A. Lewis, D.m.d., P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 107 Drennon Dr, Jesup, Georgia |
| Authorized Official Name and Position | Gary Alan Lewis (PRESIDENT) |
| Authorized Official Contact | 9124277072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary A. Lewis, D.m.d., P.a. 107 Drennon Dr Jesup GA 31545-0011 Ph: (912) 427-7072 | Gary A. Lewis, D.m.d., P.a. 107 Drennon Dr Jesup GA 31545-0011 Ph: (912) 427-7072 |
| NPI Number | 1366560401 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366560401 | NPI | - | NPPES |
| 00163732B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8778 (Georgia) | Primary |
Dental Wellness Center Of Jesup Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 135 Peachtree St, Jesup, GA 31545 Phone: 912-665-2792 Fax: 888-289-4301 |