Provider Demographics
NPI:1417001801
Name:NEWSOME, LINDA (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 US HIGHWAY 287
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8899
Mailing Address - Country:US
Mailing Address - Phone:303-664-9355
Mailing Address - Fax:303-665-0674
Practice Address - Street 1:489 US HIGHWAY 287
Practice Address - Street 2:SUITE 200
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8899
Practice Address - Country:US
Practice Address - Phone:303-664-9355
Practice Address - Fax:303-665-0674
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8048122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist