Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 7734 | MD |
NPI | 1003098740 |
---|---|
Provider Name | Dr. Frank Lewis |
First Address | Farmington Hills, MI 48331-3354 |
Second Address | Germantown, MD 20876-5906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2007 |
Last Update Date | 05/12/2007 |