Provider Demographics
NPI:1952598906
Name:MULLINS, NEWTON CARROLL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEWTON
Middle Name:CARROLL
Last Name:MULLINS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 COMMONWEALTH DR
Mailing Address - Street 2:NORTON
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-4051
Mailing Address - Country:US
Mailing Address - Phone:276-679-7171
Mailing Address - Fax:276-679-7222
Practice Address - Street 1:728 COMMONWEALTH DR
Practice Address - Street 2:NORTON
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-4051
Practice Address - Country:US
Practice Address - Phone:276-679-7171
Practice Address - Fax:276-679-7222
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401004680122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist