# CLIFTON S. CAMERON DDS II-LEESVILLE, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Vista Oral Surgery and Implants - Raleigh
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366299091
- **Authorized official:** MARINA R (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (202) 630-3939

## Contact information

- **Practice address:** 9305 LEESVILLE RD STE 102, RALEIGH, NC 27613-7603
- **Practice address phone:** (919) 964-2722
- **Mailing address:** 9305 LEESVILLE RD STE 102, RALEIGH, NC 27613-7603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2024
- **Last updated:** 02/06/2025