Lewis, Gordon Robert

Lewis, Gordon Robert is an sole proprietor health care provider with primary practice located at 3142 Harrison Ave , Eureka CA 95503-5638. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Lewis, Gordon Robert can be contacted via phone (707) 445-1104.

Contact Information

Primary practice address
3142 Harrison Ave Eureka CA 95503-5638
Phone: (707) 445-1104
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 48315 California

Profile Details

NPI number 1497822001
LBN Legal business name Lewis, Gordon Robert
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 29th, 2006
Last updated Feb 25th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497822001 NPPES
California Other 48315 DENTAL LICENSE

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