Individual
DR. JAY V LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2401 E BROADWAY, LOGANSPORT, IN 46947-2056
(574) 722-3107
Mailing address
2401 E BROADWAY, P.O. BOX 1327, LOGANSPORT, IN 46947-2056
(574) 722-3107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008646
IN
Other
Enumeration date
02/18/2007
Last updated
07/08/2007
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