Individual
SUSANNA CAMMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
605 RANDOLPH RD, LAWTON, OK 73503-4535
(580) 442-4002
Mailing address
652 HAMILTON ROAD, LAWTON, OK 73503
(580) 442-4002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60797
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60797
DENTAL LICENSE
CA
Enumeration date
09/09/2011
Last updated
09/09/2011
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