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General NPI Number Information
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NPI Number | 1124511787
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Entity Type | Individual
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Provider Name | HENRY ARTHUR LEWIS DMD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 4890 E BONANZA RD
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City | LAS VEGAS
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State | NV
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Zip | 89110-3458
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Country | US
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Telephone | 702-649-6859
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 520
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City | MOAPA
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State | NV
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Zip | 89025-0520
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Country | US
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Telephone | 702-649-6859
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7173
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License Number State | NV
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