Provider Demographics
NPI:1780626267
Name:NEWTON, CARL W (DDS,MSD)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:W
Last Name:NEWTON
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 GUION RD
Mailing Address - Street 2:#280
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-7602
Mailing Address - Country:US
Mailing Address - Phone:317-924-3228
Mailing Address - Fax:317-924-3737
Practice Address - Street 1:3750 GUION RD
Practice Address - Street 2:#280
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-7602
Practice Address - Country:US
Practice Address - Phone:317-924-3228
Practice Address - Fax:317-924-3737
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007268A1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics