Individual
DR. MARK DAVID LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7890 W ANN RD, SUITE 150, LAS VEGAS, NV 89149-5209
(702) 878-4397
(702) 658-8741
Mailing address
7890 W ANN RD, SUITE 150, LAS VEGAS, NV 89149-5209
(702) 878-4397
(702) 658-8741
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
341592992
UT
1223G0001X
General Practice Dentistry
Primary
4775
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341592992
DENTIST LICENSE
UT
Enumeration date
06/27/2006
Last updated
01/21/2015
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