Individual
DR. CHRISTINA LATRICIA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
24293 TELEGRAPH RD, SUITE 212, SOUTHFIELD, MI 48034-3011
(248) 223-5639
(248) 223-5689
Mailing address
24293 TELEGRAPH RD, STE 212, SOUTHFIELD, MI 48033-7903
(734) 728-1621
(734) 722-2331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901017597
MI
1223G0001X
General Practice Dentistry
4949T
NV
1223G0001X
General Practice Dentistry
55018
CA
1223G0001X
General Practice Dentistry
5835
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4093385
—
MI
01
—
D800438
BLUE CROSS/BLUE SHIELD
MI
Enumeration date
10/27/2006
Last updated
03/11/2016
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