Provider Demographics
NPI:1437240660
Name:NEWMAN, BRUCE GILBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:GILBERT
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W148N7397 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-4517
Mailing Address - Country:US
Mailing Address - Phone:262-251-1178
Mailing Address - Fax:
Practice Address - Street 1:4455 W BRADLEY RD
Practice Address - Street 2:207
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-3763
Practice Address - Country:US
Practice Address - Phone:414-354-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI809G1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice