Provider Demographics
NPI:1710907852
Name:NEWMAN, MICHAEL J (DMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 LINCOLN AVE.
Mailing Address - Street 2:SUITE #2
Mailing Address - City:RUMFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04276
Mailing Address - Country:US
Mailing Address - Phone:207-364-4151
Mailing Address - Fax:207-369-0653
Practice Address - Street 1:210 LINCOLN AVE.
Practice Address - Street 2:SUITE #2
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276
Practice Address - Country:US
Practice Address - Phone:207-364-4151
Practice Address - Fax:207-369-0653
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice