Provider Demographics
NPI:1952345985
Name:CAMPBELL, PAUL E (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:CAMPBELL
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 1:65 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1232
Mailing Address - Country:US
Mailing Address - Phone:603-726-6065
Mailing Address - Fax:
Practice Address - Street 1:65 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1232
Practice Address - Country:US
Practice Address - Phone:603-536-4301
Practice Address - Fax:603-536-1984
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH29901223G0001X
NH02990122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433783099Medicaid
NH30307141Medicaid