Provider Demographics
NPI:1245339092
Name:J. E. CAMERON, D.D.S.
Entity type:Organization
Organization Name:J. E. CAMERON, D.D.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-247-6704
Mailing Address - Street 1:501 ATLANTIC BEACH CSWY
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28512-7341
Mailing Address - Country:US
Mailing Address - Phone:252-247-6704
Mailing Address - Fax:252-247-3670
Practice Address - Street 1:501 ATLANTIC BEACH CSWY
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:NC
Practice Address - Zip Code:28512-7341
Practice Address - Country:US
Practice Address - Phone:252-247-6704
Practice Address - Fax:252-247-3670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC014RAOtherBCBS
NC89014RAMedicaid