1811204902

Everything you always wanted to know about DR. NEWSOME MICHELLE ELISE D.D.S but were afraid to ask.

DR. NEWSOME MICHELLE ELISE D.D.S

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. NEWSOME MICHELLE ELISE D.D.S
Gender:
Female
Enumeration date:
2010-09-10
Last update date:
2012-06-07
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
263880403 Medicaid none NC

Taxonomies

Taxonomy State License Number Primary?
1223G0001X General Practice NC 9201 Y

Phone Numbers

Type Number
Practice Location Address Fax Number 9194848044
Practice Location Address Telephone Number 9194848088
Mailing Address Telephone Number 9193088018

Addresses

Type Address City State Postal Country
Mailing Address 1221 NORTHCREEK DR SUITE C DURHAM NC 27707 NC
Practice Location Address 104 W. NORTHWOOD STREET GREENSBORO NC 27401 NC

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