Organization
JASON D LEWIS DDS PA
Active
Other names
BARTRAM DENTAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON DEAN LEWIS DDS (OWNER/DENTIST)
(904) 201-6000
Entity
Organization
Contact information
Practice address
130 GATEWAY CIR, JACKSONVILLE, FL 32259-4003
(904) 201-6000
(904) 201-6004
Mailing address
130 GATEWAY CIR, JACKSONVILLE, FL 32259-4003
(904) 201-6000
(904) 201-6004
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
DN16561
FL
Other
Enumeration date
04/03/2012
Last updated
05/30/2012
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