Individual
DR. BRADLEY B LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3400 PACIFIC AVE APT 305, MARINA DEL REY, CA 90292-7816
(424) 228-4882
Mailing address
3400 PACIFIC AVE APT 305, MARINA DEL REY, CA 90292-7816
(310) 780-0567
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
331117
CA
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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