Individual
PHOEBY K LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1536 EISENHOWER PKWY, MACON, GA 31206-3130
(478) 781-4333
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(716) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011094
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007529
DORAL
GA
01
—
100678
AVESIS
GA
05
—
559750905A
—
GA
01
—
81635
UNITED CONC.
GA
Enumeration date
06/14/2006
Last updated
05/18/2010
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