Healthcare Provider Details

I. General information

NPI: 1144548702
Provider Name (Legal Business Name): ANNA E. NEWMAN, D.M.D., PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 05/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 MAIN ST
PARIS KY
40361-1813
US

IV. Provider business mailing address

436 MAIN ST
PARIS KY
40361-1813
US

V. Phone/Fax

Practice location:
  • Phone: 859-987-5550
  • Fax: 859-987-2465
Mailing address:
  • Phone: 859-987-5550
  • Fax: 859-987-2465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6485
License Number StateKY

VIII. Authorized Official

Name: MARY BROWN BROWN
Title or Position: OFFICE MANAGER
Credential:
Phone: 859-987-5550