Provider Demographics
NPI:1508182650
Name:GARY CAMERON, DDS, P.C.
Entity Type:Organization
Organization Name:GARY CAMERON, DDS, P.C.
Other - Org Name:ASHEBORO DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE/CREDENTAILING
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDIEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-5100
Mailing Address - Street 1:350 N COX ST STE 18
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5514
Mailing Address - Country:US
Mailing Address - Phone:336-625-4216
Mailing Address - Fax:336-629-9317
Practice Address - Street 1:350 N COX ST STE 18
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5514
Practice Address - Country:US
Practice Address - Phone:336-625-4216
Practice Address - Fax:336-629-9317
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARY CAMERON, DDS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-14
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty