Provider Demographics
NPI:1538331004
Name:WILLIAM H. LEWIS, JR. DDS PA
Entity Type:Organization
Organization Name:WILLIAM H. LEWIS, JR. DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-548-9678
Mailing Address - Street 1:201 N DALTON ST
Mailing Address - Street 2:PO BOX 330
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-1903
Mailing Address - Country:US
Mailing Address - Phone:336-548-9678
Mailing Address - Fax:336-548-4528
Practice Address - Street 1:201 N DALTON ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-1903
Practice Address - Country:US
Practice Address - Phone:336-548-9678
Practice Address - Fax:336-548-4528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2878261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental