Provider Demographics
NPI:1093418451
Name:DAVID L CAMERON, DMD, MS, PLLC
Entity Type:Organization
Organization Name:DAVID L CAMERON, DMD, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:976-869-3789
Mailing Address - Street 1:2940 N CHURCH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-6617
Mailing Address - Country:US
Mailing Address - Phone:801-544-1184
Mailing Address - Fax:
Practice Address - Street 1:2940 N CHURCH ST STE 302
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-6617
Practice Address - Country:US
Practice Address - Phone:801-544-1184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty