| NPI | 1346458304 | 
|---|---|
| Other Name | CHANNING LESTER EWING | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 122300000X Dentist (Licence: LA 4547) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 4547) | 
| Enumeration Date | 2007-05-21 | 
| Last Update Date | 2025-09-11 |