Provider Demographics
NPI:1851516512
Name:LEWIS, THOMAS STEWART (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:STEWART
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:CA
Mailing Address - Zip Code:93221-1836
Mailing Address - Country:US
Mailing Address - Phone:559-592-3431
Mailing Address - Fax:559-592-6544
Practice Address - Street 1:441 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-1836
Practice Address - Country:US
Practice Address - Phone:559-592-3431
Practice Address - Fax:559-592-6544
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0331181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice