Individual
DR. GARY LEWELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
720 BENNETT AVE, MEDFORD, OR 97504-6722
(541) 772-8280
(541) 734-7771
Mailing address
720 BENNETT AVE, MEDFORD, OR 97504-6722
(541) 772-8280
(541) 734-7771
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3764
OR
Other
Enumeration date
11/12/2008
Last updated
11/12/2008
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