Individual
DR. SCOTT RICHARD LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
300 N 2ND E, REXBURG, ID 83440-1604
(208) 356-9459
(208) 356-5500
Mailing address
300 N 2ND E, REXBURG, ID 83440-1604
(208) 356-9459
(208) 356-5500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3462
ID
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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