Provider Demographics
NPI:1821149675
Name:CAMPBELL, DAVID LEON (DDS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEON
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 1:9310 APISON PIKE
Mailing Address - Street 2:SUITE #5
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363
Mailing Address - Country:US
Mailing Address - Phone:423-396-3712
Mailing Address - Fax:423-531-4181
Practice Address - Street 1:9310 APISON PIKE
Practice Address - Street 2:
Practice Address - City:O COLLEGEDALE
Practice Address - State:TN
Practice Address - Zip Code:37315
Practice Address - Country:US
Practice Address - Phone:423-396-3712
Practice Address - Fax:423-531-4181
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS068371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice