Organization
GARY A. LEWIS, D.M.D., P.A.
Active
Organization
GARY A. LEWIS, D.M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ALAN LEWIS (PRESIDENT)
(912) 427-7072
Entity
Organization
Contact information
Practice address
107 DRENNON DR, JESUP, GA 31545-0011
(912) 427-7072
(912) 427-9350
Mailing address
107 DRENNON DR, JESUP, GA 31545-0011
(912) 427-7072
(912) 427-9350
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8778
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00163732B
—
GA
Enumeration date
03/27/2007
Last updated
08/22/2020
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