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General NPI Number Information
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NPI Number | 1356966352
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Entity Type | Individual
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Provider Name | PAUL LEWIS DDS
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Gender | Male
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 301 N MAIN ST STE 1420
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City | WICHITA
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State | KS
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Zip | 67202-4814
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Country | US
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Telephone | 316-265-0849
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N MAIN ST STE 1420
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City | WICHITA
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State | KS
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Zip | 67202-4814
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DRPM2205
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61597
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License Number State | KS
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