Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 04515 | CO |
N | 1223G0001X | General Practice | 104515 | CO |
N | 213EG0000X | General Practice | 104515 | CO |
NPI | 1659378701 |
---|---|
Provider Name | Dr. Dennis James Lewis |
First Address | Louisville, CO 80027-1345 |
Second Address | Louisville, CO 80027-1345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 25/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02045151 | (05) | CO |
04004172 | (05) | CO |