# JEAN A. LEWIS DMD, PC

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

## Provider details

- **NPI number:** 1306071667
- **Authorized official:** DR. JEAN A. LEWIS DMD (PRESIDENT)
- **Authorized official phone:** (520) 490-5743

## Contact information

- **Practice address:** 1245 SE 3RD ST STE A1, BEND, OR 97702-2162
- **Practice address phone:** (520) 490-5743
- **Mailing address:** 1245 SE 3RD ST STE A1, BEND, OR 97702-2162
- **Mailing address phone:** (520) 490-5743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | D9804 | OR | Yes |

## Other

- **Enumeration date:** 05/15/2009
- **Last updated:** 01/22/2013