Provider Demographics
NPI:1336278175
Name:GUY, NEWTON SAMUEL III (DMD)
Entity Type:Individual
Prefix:
First Name:NEWTON
Middle Name:SAMUEL
Last Name:GUY
Suffix:III
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:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:KY
Mailing Address - Zip Code:40831
Mailing Address - Country:US
Mailing Address - Phone:606-573-4707
Mailing Address - Fax:
Practice Address - Street 1:303 MOUND ST
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:KY
Practice Address - Zip Code:40831
Practice Address - Country:US
Practice Address - Phone:606-573-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60040037Medicaid