Provider Demographics
NPI:1902193048
Name:LAHUE, CAMILLE ROGERS (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:ROGERS
Last Name:LAHUE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 N HIGHWAY 377
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-9103
Mailing Address - Country:US
Mailing Address - Phone:817-837-4545
Mailing Address - Fax:
Practice Address - Street 1:1224 N HIGHWAY 377
Practice Address - Street 2:SUITE 211
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-9103
Practice Address - Country:US
Practice Address - Phone:817-837-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry