Lewis, Kenneth Dwayne

Lewis, Kenneth Dwayne is an sole proprietor health care provider with primary practice located at 1149 E 42Nd St , Odessa TX 79762-7723. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Lewis, Kenneth Dwayne can be contacted via phone (432) 362-7927.

Contact Information

Primary practice address
1149 E 42Nd St Odessa TX 79762-7723
Phone: (432) 362-7927
Fax: (432) 362-7928
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 15924 Texas

Profile Details

NPI number 1871505529
LBN Legal business name Lewis, Kenneth Dwayne
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2006
Last updated Jul 8th, 2007 - 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 1871505529 NPPES
Texas Other D15924 BCBS

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