Individual
DR. SHANE LEE NEWTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
307 E PARK ST STE 103, MCCALL, ID 83638-3863
(208) 634-5255
(208) 634-1047
Mailing address
307 E PARK ST STE 103, MCCALL, ID 83638-3863
(208) 634-5255
(208) 634-1047
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3280
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807401600
—
ID
Enumeration date
11/14/2006
Last updated
07/21/2022
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