# NEWPORT FAMILY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346946175
- **Authorized official:** MR. ROGER FITZWATER JR. (OWNER)
- **Authorized official phone:** (717) 278-4199

## Contact information

- **Practice address:** 91 NEWPORT RD STE 101, GAP, PA 17527-9579
- **Practice address phone:** (717) 442-8264
- **Mailing address:** 91 NEWPORT RD STE 101, GAP, PA 17527-9579
- **Mailing address phone:** (717) 442-8264

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2023
- **Last updated:** 02/02/2023