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General NPI Number Information
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NPI Number | 1518124544
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Entity Type | Organization
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Legal Business Name | DR. CRAIG E. NEWELL P.C.
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 611 18TH ST
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City | SPIRIT LAKE
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State | IA
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Zip | 51360-1502
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Country | US
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Telephone | 712-336-3428
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 407 611-18TH STREET
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City | SPIRIT LAKE
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State | IA
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Zip | 51360-0407
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Country | US
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Telephone | 712-336-3428
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG ELLIOTT NEWELL
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Credential | D.D.S.,M.S.
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Telephone | 712-336-3428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6144
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License Number State | IA
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