Organization
CAMPBELL DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON MICHAEL CAMPBELL (OWNER)
(770) 868-8788
Entity
Organization
Contact information
Practice address
48 PIEDMONT DR, SUITE 302, WINDER, GA 30680-8131
(770) 868-8788
Mailing address
48 PIEDMONT DR, SUITE 302, WINDER, GA 30680-8131
(770) 868-8788
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012764
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100615
DR. CAMPBELL DORAL #
GA
01
—
9182246
DR. CLARKSON DORAL #
GA
01
—
9182323
DR. CAMPBELL AVESIS #
GA
Enumeration date
05/07/2007
Last updated
08/22/2020
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