Healthcare Provider Details

I. General information

NPI: 1609896646
Provider Name (Legal Business Name): JAMES B. NEWTON DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 WESTERN AVE
MANCHESTER ME
04351-0450
US

IV. Provider business mailing address

PO BOX 450
MANCHESTER ME
04351-0450
US

V. Phone/Fax

Practice location:
  • Phone: 207-621-0136
  • Fax: 207-621-6324
Mailing address:
  • Phone: 207-621-0136
  • Fax: 207-621-6324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number200-3337
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: