Provider Demographics
NPI:1720092745
Name:CAMPBELL, LELAND QUINTEN II (DDS)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:QUINTEN
Last Name:CAMPBELL
Suffix:II
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 1:1515 PORTAGE ST NW
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2290
Mailing Address - Country:US
Mailing Address - Phone:330-494-3201
Mailing Address - Fax:330-494-3597
Practice Address - Street 1:1515 PORTAGE ST NW
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2290
Practice Address - Country:US
Practice Address - Phone:330-494-3201
Practice Address - Fax:330-494-3597
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist