Organization
LEWIS A. WILK, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEWIS A. WILK D.M.D. (OWNER)
(570) 421-3512
Entity
Organization
Contact information
Practice address
1101 N FIFTH ST, STROUDSBURG, PA 18360
(570) 421-3512
(570) 420-8134
Mailing address
1101 N FIFTH ST, STROUDSBURG, PA 18360
(570) 421-3512
(570) 420-8134
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
018990-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081994
BLUE SHIELD
PA
Enumeration date
03/14/2007
Last updated
08/05/2010
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