Provider Demographics
NPI:1992707061
Name:LEWIS, LINDA S (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5750
Mailing Address - Country:US
Mailing Address - Phone:610-253-2481
Mailing Address - Fax:
Practice Address - Street 1:325 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5750
Practice Address - Country:US
Practice Address - Phone:610-253-2481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019964L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice