Provider Demographics
NPI:1467947077
Name:SPAULDING, CAMERON KEITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:KEITH
Last Name:SPAULDING
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 1:2214 BARNES DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-4431
Mailing Address - Country:US
Mailing Address - Phone:615-476-2937
Mailing Address - Fax:
Practice Address - Street 1:121 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:TN
Practice Address - Zip Code:37184-1314
Practice Address - Country:US
Practice Address - Phone:615-237-3631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10820.1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice