Provider Demographics
NPI:1760699300
Name:CAMPBELL, VANESSA MENGUSER (DDS)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:MENGUSER
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 1:420 VILLAGE WALK DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540
Mailing Address - Country:US
Mailing Address - Phone:919-760-3526
Mailing Address - Fax:
Practice Address - Street 1:420 VILLAGE WALK DRIVE
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540
Practice Address - Country:US
Practice Address - Phone:919-760-3526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC80761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice