Individual
DR. ROBERT DELL LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
9776 W STATE ST, STAR, ID 83669-5766
(208) 898-4080
(208) 898-4095
Mailing address
9776 W STATE ST, STAR, ID 83669-5766
(208) 898-4080
(208) 898-4095
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4065
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808628400
—
ID
Enumeration date
07/25/2007
Last updated
07/12/2012
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