Provider Demographics
NPI:1093334443
Name:CAMPBELL, CONOR (DMD)
Entity type:Individual
Prefix:DR
First Name:CONOR
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 SILVERSIDE RD STE 12
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4913
Mailing Address - Country:US
Mailing Address - Phone:302-477-1800
Mailing Address - Fax:302-477-0343
Practice Address - Street 1:3512 SILVERSIDE RD STE 12
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4913
Practice Address - Country:US
Practice Address - Phone:845-649-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00115681223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery