Individual
TED CHARLES LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4780 CRANDALL LANESVILLE RD NE, CORYDON, IN 47112-7058
(573) 380-6235
Mailing address
4780 CRANDALL LANESVILLE RD NE, CORYDON, IN 47112-7058
(573) 380-6235
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012055A
IN
Other
Enumeration date
03/26/2007
Last updated
10/14/2013
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