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Individual

JANEAN LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
1105 3RD AVE N, PAYETTE, ID 83661-2407
(208) 642-9763
Mailing address
1717 COX RD, WEISER, ID 83672-5811

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1958
ID

Other

Enumeration date
10/06/2006
Last updated
07/08/2007
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