Provider Demographics
NPI:1720064611
Name:CAMPBELL, RICHARD P (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MAKALAPA DR
Mailing Address - Street 2:ATTN: PROFESSIONAL AFFAIRS COORDINATOR (N01HD)
Mailing Address - City:PEARL HARBOR
Mailing Address - State:HI
Mailing Address - Zip Code:96860-3131
Mailing Address - Country:US
Mailing Address - Phone:808-471-2463
Mailing Address - Fax:
Practice Address - Street 1:USS ABRAHAM LINCOLN (CVN 72)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96612-2872
Practice Address - Country:US
Practice Address - Phone:425-304-5092
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107821223G0001X
VA04010081251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice