# LEWIS DENTAL GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013233121
- **Authorized official:** PEETE DUANE LEWIS (OWNER)
- **Authorized official phone:** (615) 828-6811

## Contact information

- **Practice address:** 20 N WASHINGTON AVE, BROWNSVILLE, TN 38012-2555
- **Practice address phone:** (731) 779-0889
- **Mailing address:** 1299 BRIDGETON PARK DR, BRENTWOOD, TN 37027-8341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8692 | TN | Yes |

## Other

- **Enumeration date:** 04/14/2010
- **Last updated:** 04/14/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1505474 | — | TN |