Provider Demographics
NPI:1346322971
Name:LEWANDOWSKI, MARK DJ (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:DJ
Last Name:LEWANDOWSKI
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:420 EAST HOUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661
Mailing Address - Country:US
Mailing Address - Phone:989-345-1391
Mailing Address - Fax:989-345-1601
Practice Address - Street 1:420 EAST HOUGHTON AVE
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661
Practice Address - Country:US
Practice Address - Phone:989-345-1391
Practice Address - Fax:989-345-1601
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2020-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI15483208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice