Provider Demographics
NPI:1710186184
Name:CAMP, GREGORY ALEXANDER (DMD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALEXANDER
Last Name:CAMP
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8161 ARDREY KELL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-5717
Mailing Address - Country:US
Mailing Address - Phone:704-845-1425
Mailing Address - Fax:704-845-1580
Practice Address - Street 1:8161 ARDREY KELL RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-5717
Practice Address - Country:US
Practice Address - Phone:704-845-1425
Practice Address - Fax:704-845-1580
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC85921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice