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NPI Code Detail

MEDICARE: DR. LEWIS R WAYT D.D.S.

MEDICARE:  DR. LEWIS R WAYT  D.D.S.
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
1122300000XDentist5617OK
21223G0001XGeneral Practice Dentistry5617OK

General Provider Information

NPI Number : 1295833903
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEWIS R WAYT D.D.S.
Provider Business Mailing Address
First Line : 7710 SIGHTSEEING RD
Second Line : BLDG 2826
City : FORT BENNING
State : GA
Zip : 31905-3764
Country : US
Telephone Number : 706-544-3103
Fax Number :
Provider Business Practice Location Address
First Line : 7710 SIGHTSEEING RD
Second Line : BLDG 2826
City : FORT BENNING
State : GA
Zip : 31905-3764
Country : US
Telephone Number : 706-544-3103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 03/31/2017

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Directions to “ DR. LEWIS R WAYT D.D.S.” Practice Location

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