Individual
RODERICK W. LEWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD.
Contact information
Practice address
326 NICHOLS ROAD, FITCHBURG, MA 01420
(978) 878-8100
(978) 878-8326
Mailing address
326 NICHOLS ROAD, FITCHBURG, MA 01420
(978) 878-8516
(978) 878-8418
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8883
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
8888
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1319833
—
MA
01
—
221845
UGS
—
01
—
X02562
BS OF MA
MA
Enumeration date
07/25/2006
Last updated
08/27/2015
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