Provider Demographics
NPI:1679986483
Name:CAMERON, DUSTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:
Last Name:CAMERON
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 1:710 E 2550 N
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2866
Mailing Address - Country:US
Mailing Address - Phone:801-645-7585
Mailing Address - Fax:
Practice Address - Street 1:2201 N WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-7210
Practice Address - Country:US
Practice Address - Phone:801-782-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9048620-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist