Individual
JASON RICHARD LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11447 S 700 E, DRAPER, UT 84020-9731
(801) 572-5154
(801) 619-0500
Mailing address
11447 S 700 E, DRAPER, UT 84020-9731
(801) 572-5154
(801) 619-0500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
374055-9922
UT
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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