Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 0401004275 | VA |
NPI | 1003880014 |
---|---|
Provider Name | Dr. John W Newton |
First Address | Ft Huachuca, AZ 85613-7040 |
Second Address | Ft Huachuca, AZ 85613-7040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 07/07/2016 |