Provider Demographics
NPI:1245638303
Name:CAMPBELL, THOMIA (DDS)
Entity type:Individual
Prefix:
First Name:THOMIA
Middle Name:
Last Name:CAMPBELL
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 1:1221 SPRING CRK SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-2420
Mailing Address - Country:US
Mailing Address - Phone:270-366-6404
Mailing Address - Fax:
Practice Address - Street 1:5780 C H JAMES PKWY STE 280
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6076
Practice Address - Country:US
Practice Address - Phone:770-943-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122217122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist