Provider Demographics
NPI:1316603301
Name:DR CAMERON & ASSOCIATES OF DURHAM PLLC
Entity Type:Organization
Organization Name:DR CAMERON & ASSOCIATES OF DURHAM PLLC
Other - Org Name:TOTAL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-859-0444
Mailing Address - Street 1:5111 NC HIGHWAY 55 STE 102
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9687
Mailing Address - Country:US
Mailing Address - Phone:919-806-8060
Mailing Address - Fax:
Practice Address - Street 1:5111 NC HIGHWAY 55 STE 102
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9687
Practice Address - Country:US
Practice Address - Phone:919-806-8060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-13
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty