Provider Demographics
NPI:1518132760
Name:CAMPBELL, MILTON B (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILTON
Middle Name:B
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 1:7142 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2241
Mailing Address - Country:US
Mailing Address - Phone:313-864-9030
Mailing Address - Fax:313-864-0443
Practice Address - Street 1:7142 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2241
Practice Address - Country:US
Practice Address - Phone:313-864-9030
Practice Address - Fax:313-864-0443
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID11274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist