Provider Demographics
NPI:1013002153
Name:GARRISH, LEWIS M (DMD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:M
Last Name:GARRISH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 NW 43RD ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7469
Mailing Address - Country:US
Mailing Address - Phone:352-376-7335
Mailing Address - Fax:352-378-5769
Practice Address - Street 1:2441 NW 43RD ST
Practice Address - Street 2:SUITE 16
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7469
Practice Address - Country:US
Practice Address - Phone:352-376-7335
Practice Address - Fax:352-378-5769
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL77001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice