Most Relevant Information
Provider Data
| NPI Number: | 1003252917 |
| Provider Name: | KENLY LEWIS DINE DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 9496 |
Most Important Dates
| Enumeration Date: | 05/18/2013 |
| Last Updated: | 08/25/2020 |
Provider Practice Location
4140 RAMSEY ST
SUITE 104
FAYETTEVILLE
NC
283117672
Practice Location Phone/Fax
| Phone: | 9106706321 |
| Fax: |
Provider Mailing Location
4140 RAMSEY ST
SUITE 104
FAYETTEVILLE
NC
283117672
Provider Mailing Phone/Fax
| Phone: | 9106706321 |
| Fax: |