Healthcare Provider Details

I. General information

NPI: 1669393146
Provider Name (Legal Business Name): NEWG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8216 EMMA COURT
PIKE ROAD AL
36064
US

IV. Provider business mailing address

8216 EMMA COURT
PIKE ROAD AL
36064
US

V. Phone/Fax

Practice location:
  • Phone: 334-203-7002
  • Fax:
Mailing address:
  • Phone: 334-203-7002
  • Fax: 334-203-7027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH GANTT EILAND
Title or Position: OWNER
Credential:
Phone: 334-203-7002