Provider Demographics
NPI:1225926280
Name:CAMPBELL, CALEB HAROLD (DDS)
Entity type:Individual
Prefix:DR
First Name:CALEB
Middle Name:HAROLD
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50121 VICTORIA PL
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-6338
Mailing Address - Country:US
Mailing Address - Phone:586-354-6935
Mailing Address - Fax:
Practice Address - Street 1:5916 LAKE MICHIGAN DR
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-8111
Practice Address - Country:US
Practice Address - Phone:616-259-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016026911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice