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Individual

DR. ROGER DARRELL CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
826 KY 11 N, BOONEVILLE, KY 41314-9155
(606) 593-6395
(606) 593-5916
Mailing address
PO BOX 40, WHITESBURG, KY 41858-0040
(606) 633-4823
(606) 633-1874

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
6753
KY
1223G0001X
General Practice Dentistry
Primary
6753
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60067535
KY
Enumeration date
01/16/2007
Last updated
03/21/2016
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