Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS-029003-L | PA |
NPI | 1043355316 |
---|---|
Provider Name | Dr. John H. Newell JR. |
First Address | Murrysville, PA 15668-2017 |
Second Address | Murrysville, PA 15668-2017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |