| Lewis Family Dentistry, Llc | |
|
2401 E Broadway Logansport IN 46947-2056 | |
| (574) 722-3107 | |
| (574) 722-1080 |
| Full Name | Lewis Family Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2401 E Broadway, Logansport, Indiana |
| Authorized Official Name and Position | Jay Lewis (SOLE MEMBER) |
| Authorized Official Contact | 5747223107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis Family Dentistry, Llc 2401 E Broadway Logansport IN 46947-2056 Ph: (574) 722-3107 | Lewis Family Dentistry, Llc 2401 E Broadway Logansport IN 46947-2056 Ph: (574) 722-3107 |
| NPI Number | 1487106282 |
|---|---|
| Provider Enumeration Date | 10/27/2016 |
| Last Update Date | 10/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487106282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12008646 (Indiana) | Primary |
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