Healthcare Provider Details

I. General information

NPI: 1356267785
Provider Name (Legal Business Name): CAMERON J. SMALL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 CASSIDY ST
OCEANSIDE CA
92054-6033
US

IV. Provider business mailing address

1610 MORENO ST
OCEANSIDE CA
92054-5931
US

V. Phone/Fax

Practice location:
  • Phone: 760-525-0749
  • Fax:
Mailing address:
  • Phone: 760-525-0749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. CAMERON JAY SMALL
Title or Position: DENTIST
Credential: DDS
Phone: 760-525-0749