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NPI Code Detail

MEDICARE: MRS. MICHELLE LEA FRANCES LEWIS DDS

MEDICARE: MRS. MICHELLE LEA FRANCES LEWIS 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
1122300000XDentist047267NY

General Provider Information

NPI Number : 1700057866
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE LEA FRANCES LEWIS DDS
Provider Business Mailing Address
First Line : 6350 TRANSIT RD
Second Line :
City : DEPEW
State : NY
Zip : 14043-1039
Country : US
Telephone Number : 716-636-8686
Fax Number :
Provider Business Practice Location Address
First Line : 6350 TRANSIT RD
Second Line :
City : DEPEW
State : NY
Zip : 14043-1039
Country : US
Telephone Number : 716-636-8686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2008
Last Update Date : 03/17/2008

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