Provider Demographics
NPI:1376637546
Name:CAMPANY, NELSON W (DMD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:W
Last Name:CAMPANY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 W POPLAR AVE
Mailing Address - Street 2:STE.1
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2685
Mailing Address - Country:US
Mailing Address - Phone:901-853-0715
Mailing Address - Fax:901-853-1114
Practice Address - Street 1:745 W POPLAR AVE
Practice Address - Street 2:STE.1
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2685
Practice Address - Country:US
Practice Address - Phone:901-853-0715
Practice Address - Fax:901-853-1114
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS39461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice