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Individual

ROY CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RDA

Contact information

Practice address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 861-4088
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 861-4088

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
12967
CA

Other

Enumeration date
06/08/2018
Last updated
06/08/2018
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