Healthcare Provider Details

I. General information

NPI: 1225926280
Provider Name (Legal Business Name): CALEB HAROLD CAMPBELL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41829 FORD RD
CANTON MI
48187-3649
US

IV. Provider business mailing address

50121 VICTORIA PL
MACOMB MI
48044-6338
US

V. Phone/Fax

Practice location:
  • Phone: 313-723-0129
  • Fax:
Mailing address:
  • Phone: 586-354-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901602691
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: