Provider Demographics
NPI:1538487640
Name:ROBERT A CAMHI DENTAL INC
Entity Type:Organization
Organization Name:ROBERT A CAMHI DENTAL INC
Other - Org Name:CROWN DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CAMHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-474-6200
Mailing Address - Street 1:2405 HOOVER AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-6619
Mailing Address - Country:US
Mailing Address - Phone:619-474-6200
Mailing Address - Fax:
Practice Address - Street 1:2405 HOOVER AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-6619
Practice Address - Country:US
Practice Address - Phone:619-474-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty