Provider Demographics
NPI:1518088756
Name:CAMPBELL, RICHARD J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:CAMPBELL
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 1:6200 SARATOGA BLVD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3421
Mailing Address - Country:US
Mailing Address - Phone:361-992-9500
Mailing Address - Fax:361-992-1862
Practice Address - Street 1:3435 S ALAMEDA ST STE A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1797
Practice Address - Country:US
Practice Address - Phone:361-853-0381
Practice Address - Fax:361-853-1681
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice