Provider Demographics
NPI:1235802646
Name:SCHWAB, CAMERON LORRAINE (DMD)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:LORRAINE
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 ROCKY DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-1370
Mailing Address - Country:US
Mailing Address - Phone:859-987-3290
Mailing Address - Fax:859-987-6800
Practice Address - Street 1:2115 ROCKY DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-1370
Practice Address - Country:US
Practice Address - Phone:859-987-3290
Practice Address - Fax:859-987-6800
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY106551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice