Provider Demographics
NPI:1225248909
Name:LEWIS, JOELLE WERSCHKY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOELLE
Middle Name:WERSCHKY
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JORI
Other - Middle Name:W
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5225 E COOK RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8388
Mailing Address - Country:US
Mailing Address - Phone:810-695-7120
Mailing Address - Fax:810-584-7467
Practice Address - Street 1:5225 E COOK RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8388
Practice Address - Country:US
Practice Address - Phone:810-695-7120
Practice Address - Fax:810-584-7467
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010195811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice