Provider Demographics
NPI:1912381419
Name:MCMILLIN, CAMERON (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:
Last Name:MCMILLIN
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 1:10710 U.S. HWY 41
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432
Mailing Address - Country:US
Mailing Address - Phone:352-489-1767
Mailing Address - Fax:352-489-5790
Practice Address - Street 1:10710 U.S. HWY 41
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432
Practice Address - Country:US
Practice Address - Phone:352-489-1767
Practice Address - Fax:352-489-5790
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 21388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist