Individual
DR. CARISSA EVE CAMPOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3384 COBB PKWY NW STE 130, ACWORTH, GA 30101-8784
(678) 574-8622
Mailing address
3103 WOODWALK TRCE SE, ATLANTA, GA 30339-8475
(631) 355-5716
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
057724
NY
1223G0001X
General Practice Dentistry
Primary
DN122551
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2013
Last updated
10/11/2024
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