Provider Demographics
NPI:1750388948
Name:NEWMAN, DON M
Entity type:Individual
Prefix:
First Name:DON
Middle Name:M
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 EAGLE CREEK PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-4691
Mailing Address - Country:US
Mailing Address - Phone:317-293-3000
Mailing Address - Fax:319-293-6773
Practice Address - Street 1:3945 EAGLE CREEK PKWY
Practice Address - Street 2:STE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-4691
Practice Address - Country:US
Practice Address - Phone:317-293-3000
Practice Address - Fax:319-293-6773
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010178A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist