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Individual

DR. JEFFREY SCOTT LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., D.M.D.

Contact information

Practice address
200 EAST BUFFALO STREET, SUITE 304, ITHACA, NY 14850
(607) 277-7007
(607) 277-5434
Mailing address
200 EAST BUFFALO STREET, #304, ITHACA, NY 14850
(607) 277-7007
(607) 277-5434

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
544761
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
197617-1
NY

Other

Enumeration date
10/06/2006
Last updated
12/14/2016
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