Provider Demographics
NPI:1821088428
Name:CAMERON, STEPHEN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:G
Last Name:CAMERON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1212 YORK RD
Mailing Address - Street 2:SUITE A201
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6240
Mailing Address - Country:US
Mailing Address - Phone:410-337-7755
Mailing Address - Fax:410-337-7922
Practice Address - Street 1:1212 YORK RD
Practice Address - Street 2:SUITE A201
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6240
Practice Address - Country:US
Practice Address - Phone:410-337-7755
Practice Address - Fax:410-337-7922
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD065621223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT59492Medicare UPIN