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General NPI Number Information
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NPI Number | 1225198153
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Entity Type | Individual
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Provider Name | LELA I LEWIS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1014 RALPH DAVID ABERNATHY BLVD SW
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City | ATLANTA
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State | GA
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Zip | 30310-1812
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Country | US
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Telephone | 404-753-3339
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Fax | 404-753-3338
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Provider Business Mailing Address
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Address Line | 371 ANGIER CT NE
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City | ATLANTA
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State | GA
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Zip | 30312-1068
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Country | US
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Telephone | 404-438-2296
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Fax | 404-733-0819
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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 | DN009752
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License Number State | GA
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