Provider Demographics
NPI:1346324910
Name:NEWSOM, CLAUDE CLINTON JR (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:CLINTON
Last Name:NEWSOM
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3225 N MERIDIAN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-4672
Mailing Address - Country:US
Mailing Address - Phone:317-925-9218
Mailing Address - Fax:317-925-9236
Practice Address - Street 1:3225 N MERIDIAN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4672
Practice Address - Country:US
Practice Address - Phone:317-925-9218
Practice Address - Fax:317-925-9236
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN120061661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice