# JEFFERSON NEWBERN, DMD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aspen Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467879031
- **Authorized official:** AMY MARKO (VP INS OPS)
- **Authorized official phone:** (315) 454-6000

## Contact information

- **Practice address:** 2030 N DIXIE HWY, ELIZABETHTOWN, KY 42701-9495
- **Practice address phone:** (270) 763-0200
- **Practice address fax:** (270) 763-0438
- **Mailing address:** PO BOX 3189, SYRACUSE, NY 13220-3189
- **Mailing address phone:** (315) 454-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8866 | KY | Yes |

## Other

- **Enumeration date:** 03/21/2014
- **Last updated:** 03/21/2014