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General NPI Number Information
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NPI Number | 1821392408
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Entity Type | Organization
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Legal Business Name | DALE A. NEWMAN S C
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 10950 W FOREST HOME AVE SUITE 201
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City | HALES CORNERS
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State | WI
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Zip | 53130-2556
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Country | US
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Telephone | 414-427-0288
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Fax | 414-427-0655
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Provider Business Mailing Address
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Address Line | 10950 W FOREST HOME AVE SUITE 201
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City | HALES CORNERS
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State | WI
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Zip | 53130-2556
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Country | US
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Telephone | 414-427-0288
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Fax | 414-427-0655
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Authorized Official
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Title or Position | DR./OWNER
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Name | DR. DALE A. NEWMAN
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Credential | D.D.S., M.S.
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Telephone | 414-427-0288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2940-15
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License Number State | WI
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