Provider Demographics
NPI:1790729754
Name:CAMPBELL, WILLIAM D (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
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 1:5555 METRO PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4102
Mailing Address - Country:US
Mailing Address - Phone:586-977-8888
Mailing Address - Fax:
Practice Address - Street 1:5555 METRO PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4102
Practice Address - Country:US
Practice Address - Phone:586-977-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010102101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice