Provider Demographics
NPI:1467503854
Name:CAMPANA, GENE ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:ANTHONY
Last Name:CAMPANA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E KATELLA AVE STE J
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5098
Mailing Address - Country:US
Mailing Address - Phone:714-639-0122
Mailing Address - Fax:714-639-0126
Practice Address - Street 1:1500 E KATELLA AVE STE J
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5098
Practice Address - Country:US
Practice Address - Phone:714-639-0122
Practice Address - Fax:714-639-0126
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31581122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist