Provider Demographics
NPI:1023066560
Name:NEWELL, CRAIG ELLIOTT (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ELLIOTT
Last Name:NEWELL
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:611-18TH STREET
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-0407
Mailing Address - Country:US
Mailing Address - Phone:712-336-3428
Mailing Address - Fax:712-336-1722
Practice Address - Street 1:611-18TH STREET
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-0407
Practice Address - Country:US
Practice Address - Phone:712-336-3428
Practice Address - Fax:712-336-1722
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA061441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics