Provider Demographics
NPI:1487790739
Name:LEWIS, DAVID WALTER JR (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WALTER
Last Name:LEWIS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:252 WEST SWAMP ROAD
Mailing Address - Street 2:UNIT 52
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901
Mailing Address - Country:US
Mailing Address - Phone:215-345-1777
Mailing Address - Fax:215-345-8942
Practice Address - Street 1:252 WEST SWAMP ROAD
Practice Address - Street 2:UNIT 52
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-345-1777
Practice Address - Fax:215-345-8942
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA023970L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice