Provider Demographics
NPI:1508904970
Name:PETER P LEWIS, DDS,PA
Entity Type:Organization
Organization Name:PETER P LEWIS, DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-363-5115
Mailing Address - Street 1:4260 US HIGHWAY 9
Mailing Address - Street 2:HOWELL PROFESSIONAL CTR
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3351
Mailing Address - Country:US
Mailing Address - Phone:732-363-5115
Mailing Address - Fax:732-370-9392
Practice Address - Street 1:4260 US HIGHWAY 9
Practice Address - Street 2:HOWELL PROFESSIONAL CTR
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3351
Practice Address - Country:US
Practice Address - Phone:732-363-5115
Practice Address - Fax:732-370-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ076191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty