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NPI Code Detail

MEDICARE: DR. CHAD S LEWISON DDS

MEDICARE: DR. CHAD S LEWISON 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
11223G0001XGeneral Practice DentistryM954SD

General Provider Information

NPI Number : 1083837801
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHAD S LEWISON DDS
Provider Business Mailing Address
First Line : 1110 W 5TH ST
Second Line :
City : CANTON
State : SD
Zip : 57013-1543
Country : US
Telephone Number : 605-764-3179
Fax Number : 605-764-3181
Provider Business Practice Location Address
First Line : 1110 W 5TH ST
Second Line :
City : CANTON
State : SD
Zip : 57013-1543
Country : US
Telephone Number : 605-764-3179
Fax Number : 605-764-3181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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Directions to “ DR. CHAD S LEWISON DDS” Practice Location

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