MEDICARE: DR. NANCY ACAMPADO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7390	NC

General Provider Information

NPI Number	:	1952412462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY ACAMPADO D.D.S.

Provider Business Mailing Address
First Line	:	210 N CHURCH ST
Second Line	:	# 1813
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-2256
Country	:	US
Telephone Number	:	704-737-4717
Fax Number	:

Provider Business Practice Location Address
First Line	:	2820 SELWYN AVE
Second Line	:	STE. 280
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-1785
Country	:	US
Telephone Number	:	704-916-9086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/20/2011

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