Provider Demographics
NPI:1598282154
Name:CAMPBELL, SOPHIA RINGSDORF (DDS)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:RINGSDORF
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 HIGHWAY 92
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-9626
Mailing Address - Country:US
Mailing Address - Phone:641-673-8455
Mailing Address - Fax:
Practice Address - Street 1:2335 HIGHWAY 92
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-9626
Practice Address - Country:US
Practice Address - Phone:641-673-8455
Practice Address - Fax:641-673-9460
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13904122300000X
IADDS-098601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist