Provider Demographics
NPI:1356430268
Name:CAMERON, ALLEN J (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:J
Last Name:CAMERON
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 1:5785 CENTENNIAL CENTER BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149
Mailing Address - Country:US
Mailing Address - Phone:702-385-7415
Mailing Address - Fax:702-388-4386
Practice Address - Street 1:5785 CENTENNIAL CENTER BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-7108
Practice Address - Country:US
Practice Address - Phone:702-385-7415
Practice Address - Fax:702-388-4386
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice