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Individual

DR. KENNETH BOYD LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4140 RAMSEY ST STE 104, FAYETTEVILLE, NC 28311-7658
(910) 488-0518
(910) 630-2432
Mailing address
4140 RAMSEY ST STE 104, FAYETTEVILLE, NC 28311-7658
(910) 488-0518
(910) 630-2432

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5029
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
507178
UNITED CONCORDIA
NC
05
8995255
NC
01
95255
BCBSNC
NC
Enumeration date
01/11/2006
Last updated
07/19/2022
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