Provider Demographics
NPI:1780656587
Name:CAMPBELL, DAVID BENNETT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BENNETT
Last Name:CAMPBELL
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 1:3200 BROADWAY BLVD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1573
Mailing Address - Country:US
Mailing Address - Phone:972-864-8119
Mailing Address - Fax:972-926-0630
Practice Address - Street 1:3200 BROADWAY BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1573
Practice Address - Country:US
Practice Address - Phone:972-864-8119
Practice Address - Fax:972-926-0630
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice