Healthcare Provider Details

I. General information

NPI: 1619007549
Provider Name (Legal Business Name): PHILIP M CAMFIELD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3168 TURNER ST
PLACERVILLE CA
95667-5756
US

IV. Provider business mailing address

4201 KILT CIR
EL DORADO HILLS CA
95762-5647
US

V. Phone/Fax

Practice location:
  • Phone: 530-622-0874
  • Fax:
Mailing address:
  • Phone: 916-933-0906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number24278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: