Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 16138 | MI |
NPI | 1679628903 |
---|---|
Provider Name | Dr. Lewis Scott Case |
First Address | Dearborn, MI 48124-3008 |
Second Address | Dearborn, MI 48124-3008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |