Provider Demographics
NPI:1497110753
Name:CAMERON & ROMAN PLLC
Entity Type:Organization
Organization Name:CAMERON & ROMAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-988-5483
Mailing Address - Street 1:2301 ROBESON ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5640
Mailing Address - Country:US
Mailing Address - Phone:910-391-1502
Mailing Address - Fax:
Practice Address - Street 1:2301 ROBESON ST
Practice Address - Street 2:SUITE 302
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5640
Practice Address - Country:US
Practice Address - Phone:910-391-1502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC85491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty