Individual
DR. JONATHAN ELLIOTT LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
20408 ROCKAWAY POINT BLVD, BREEZY POINT, NY 11697-1115
(718) 474-6500
Mailing address
20408 ROCKAWAY POINT BLVD, BREEZY POINT, NY 11697-1115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063288
NY
122300000X
Dentist
DS043203
PA
Other
Enumeration date
06/21/2021
Last updated
09/30/2024
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