Provider Demographics
NPI:1942608344
Name:WILLIAM R. NEWELL, DMD, P.C.
Entity Type:Organization
Organization Name:WILLIAM R. NEWELL, DMD, P.C.
Other - Org Name:NEWELL ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-424-6477
Mailing Address - Street 1:316 FOUNTAINHEAD DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-6710
Mailing Address - Country:US
Mailing Address - Phone:706-387-0122
Mailing Address - Fax:
Practice Address - Street 1:1681 OLD PENDERGRASS RD
Practice Address - Street 2:SUITE 195
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-2718
Practice Address - Country:US
Practice Address - Phone:706-387-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty