Individual
DR. LEWIS W. IRBY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
929 S MAIN ST, BLACKSTONE, VA 23824-2610
(434) 292-3695
(434) 292-5669
Mailing address
PO BOX 458, BLACKSTONE, VA 23824-0458
(434) 292-3695
(434) 292-5669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005837
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007817746
—
VA
01
—
113167
UNITED CONCORDIA
—
01
—
13625
DORAL DENTAL
—
01
—
45334
ANTHEM
—
Enumeration date
02/11/2008
Last updated
02/11/2008
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