Provider Demographics
NPI:1184887812
Name:CAMPBELL, STEVEN W (DMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CRESCENT GRN STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8118
Mailing Address - Country:US
Mailing Address - Phone:919-233-8830
Mailing Address - Fax:919-233-7168
Practice Address - Street 1:1400 CRESCENT GRN STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8118
Practice Address - Country:US
Practice Address - Phone:919-233-8830
Practice Address - Fax:919-233-7168
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103671223E0200X
TX239471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics