Provider Demographics
NPI:1407832280
Name:CAMPBELL, DENNIS RICHARD (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RICHARD
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 ASHELAND AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4005
Mailing Address - Country:US
Mailing Address - Phone:828-254-7921
Mailing Address - Fax:828-254-9487
Practice Address - Street 1:172 ASHELAND AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4005
Practice Address - Country:US
Practice Address - Phone:828-254-7921
Practice Address - Fax:828-254-9487
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC48371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8991338Medicaid
1154536076OtherBILLING NPI
NC1407832280OtherINDIVIDUAL NPI
NC8991338Medicaid