Organization
SOUTHWEST CENTER FOR FACIAL AND ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC S LEWIS DMD (OWNER)
(601) 249-0045
Entity
Organization
Contact information
Practice address
212 ROWLS DRIVE, MCCOMB, MS 39648
(601) 249-0045
(601) 249-0105
Mailing address
212 ROWLS DRIVE, MCCOMB, MS 39648
(601) 249-0045
(601) 249-0105
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660038
—
MS
Enumeration date
12/05/2006
Last updated
08/22/2020
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