Healthcare Provider Details

I. General information

NPI: 1013236025
Provider Name (Legal Business Name): SAMANTHA A CAMPBELL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 TURNPIKE DR 208
WESTMINSTER CO
80031
US

IV. Provider business mailing address

8501 TURNPIKE DR 208
WESTMINSTER CO
80031
US

V. Phone/Fax

Practice location:
  • Phone: 303-424-7757
  • Fax: 303-403-0268
Mailing address:
  • Phone: 303-424-7757
  • Fax: 303-403-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number9485
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: