Individual
DR. ERIC STREET LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
212 RAWLS DR, MCCOMB, MS 39648-2870
(601) 249-0045
(601) 249-0105
Mailing address
212 RAWLS DR, MCCOMB, MS 39648-2870
(601) 249-0045
(601) 249-0105
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2494-89
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660038
—
MS
Enumeration date
01/09/2008
Last updated
01/09/2008
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