Provider Demographics
NPI:1205941556
Name:CAMPBELL, HENRY A (DDS,PA)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:A
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 N JOSEY LN STE 102
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2486
Mailing Address - Country:US
Mailing Address - Phone:972-939-2888
Mailing Address - Fax:972-939-2891
Practice Address - Street 1:3730 N JOSEY LN STE 102
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2486
Practice Address - Country:US
Practice Address - Phone:972-939-2888
Practice Address - Fax:972-939-2891
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD109351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice