Provider Demographics
NPI:1790055044
Name:DR. CAMERON & ASSOCIATES OF FUQUAY, PLLC
Entity Type:Organization
Organization Name:DR. CAMERON & ASSOCIATES OF FUQUAY, PLLC
Other - Org Name:TRIANGLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HESHAM
Authorized Official - Middle Name:SAMY
Authorized Official - Last Name:ABDELBAKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-977-0627
Mailing Address - Street 1:1625 N MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-5399
Mailing Address - Country:US
Mailing Address - Phone:919-977-0627
Mailing Address - Fax:
Practice Address - Street 1:1625 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-5399
Practice Address - Country:US
Practice Address - Phone:919-977-0627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC83691223G0001X
NC84321223G0001X
1223G0001X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty