Individual
JEROLD CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
106 MERCHANTS DRIVE, OXFORD, MS 38655
(901) 870-5529
Mailing address
106 MERCHANTS DRIVE, OXFORD, MS 38655
(901) 870-5529
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4120-20
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2018
Last updated
06/20/2022
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