Organization
LEWIS DENTAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEETE DUANE LEWIS (OWNER)
(615) 828-6811
Entity
Organization
Contact information
Practice address
20 N WASHINGTON AVE, BROWNSVILLE, TN 38012-2555
(731) 779-0889
Mailing address
1299 BRIDGETON PARK DR, BRENTWOOD, TN 37027-8341
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8692
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1505474
—
TN
Enumeration date
04/14/2010
Last updated
04/14/2010
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