Provider Demographics
NPI:1306394606
Name:RINA CAMPBELL DMD, INC
Entity Type:Organization
Organization Name:RINA CAMPBELL DMD, INC
Other - Org Name:NORCAL ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:510-520-6326
Mailing Address - Street 1:262 GOLF LINKS ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-5605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 DECOTO RD
Practice Address - Street 2:SUITE 6
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-4940
Practice Address - Country:US
Practice Address - Phone:510-520-6326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS609211223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty