Individual
DR. CAMERON JUDD EGBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
642 KIRBY LN STE 101, SPANISH FORK, UT 84660-5753
(801) 798-9500
(801) 798-5466
Mailing address
8426 STICKNEY AVE, WAUWATOSA, WI 53226-2809
(801) 450-2019
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7835316
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033320957
—
UT
Enumeration date
05/24/2007
Last updated
05/23/2018
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