Individual
KELLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1325 MILTON ST, PITTSBURGH, PA 15218-1234
(703) 819-5276
Mailing address
1325 MILTON ST, PITTSBURGH, PA 15218-1234
(703) 819-5276
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401412516
VA
1223P0221X
Pediatric Dentistry
Primary
DS039890
PA
Other
Enumeration date
05/18/2010
Last updated
05/04/2016
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