MEDICARE: RICHARD A LEWANDOWSKI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	18103	OH

General Provider Information

NPI Number	:	1083816771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A LEWANDOWSKI DDS

Provider Business Mailing Address
First Line	:	4333 MONROE ST STE G
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1937
Country	:	US
Telephone Number	:	419-475-6228
Fax Number	:

Provider Business Practice Location Address
First Line	:	4333 MONROE ST STE G
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1937
Country	:	US
Telephone Number	:	419-475-6228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	07/08/2007

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