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General NPI Number Information
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NPI Number | 1538365952
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Entity Type | Organization
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Legal Business Name | NEWMAN DENTAL CARE, INC
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 500 E WOODROW WILSON AVE BUILDING E
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City | JACKSON
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State | MS
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Zip | 39216-4538
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Country | US
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Telephone | 601-366-7113
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Fax | 601-366-7114
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Provider Business Mailing Address
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Address Line | 500 E WOODROW WILSON AVE BUILDING E
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City | JACKSON
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State | MS
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Zip | 39216-4538
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Country | US
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Telephone | 601-366-7113
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Fax | 601-366-7114
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANTHONY DAVID NEWMAN
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Credential | D.M.D.
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Telephone | 601-366-7113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3197-01
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License Number State | MS
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