Provider Demographics
NPI:1275540148
Name:NEWCOMER, RICHARD DWIGHT (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DWIGHT
Last Name:NEWCOMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DICK
Other - Middle Name:
Other - Last Name:NEWCOMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DICK NEWCOMER
Mailing Address - Street 1:7825 FLORENCE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3727
Mailing Address - Country:US
Mailing Address - Phone:562-928-8900
Mailing Address - Fax:562-928-9130
Practice Address - Street 1:7825 FLORENCE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3727
Practice Address - Country:US
Practice Address - Phone:562-928-8900
Practice Address - Fax:562-928-9180
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA199431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice