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General NPI Number Information
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NPI Number | 1699828681
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Entity Type | Individual
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Provider Name | WINONA MAE NEWMAN DMD
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Gender | Female
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Dates
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Enumeration Date | 01/21/2007
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 3112 DICK POND ROAD
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City | MYRTLE BEACH
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State | SC
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Zip | 29588-4833
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Country | US
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Telephone | 843-294-5437
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Fax | 843-294-5440
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Provider Business Mailing Address
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Address Line | 3112 DICK POND ROAD
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City | MYRTLE BEACH
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State | SC
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Zip | 29588-4833
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Country | US
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Telephone | 843-294-5437
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Fax | 843-294-5440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3125
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401008654
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 012326
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0476 PD
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License Number State | SC
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