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General NPI Number Information
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NPI Number | 1952256661
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Entity Type | Organization
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Legal Business Name | S. JOEL TEWIS, DDS, A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 311 PALACE DR
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City | HAMMOND
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State | LA
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Zip | 70403-6072
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Country | US
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Telephone | 985-318-0876
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Fax |
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Provider Business Mailing Address
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Address Line | 311 PALACE DR
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City | HAMMOND
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State | LA
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Zip | 70403-6072
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Country | US
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Telephone | 985-318-0876
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Fax |
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Authorized Official
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Title or Position | MANAGING DENTIST
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Name | KALLANTHOMAS ELLE
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Credential | DMD
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Telephone | 985-318-0876
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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 |
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License Number State |
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