Healthcare Provider Details

I. General information

NPI: 1346352127
Provider Name (Legal Business Name): GARY LYNN CAMERON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GARY LYNN CAMERON DDS

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N COX ST SUITE 18
ASHEBORO NC
27203
US

IV. Provider business mailing address

350 N COX ST SUITE 18
ASHEBORO NC
27203
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-4216
  • Fax: 336-629-9317
Mailing address:
  • Phone: 336-625-4216
  • Fax: 336-629-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4327
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: