Healthcare Provider Details

I. General information

NPI: 1407832280
Provider Name (Legal Business Name): DENNIS RICHARD CAMPBELL D.D.S., P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 ASHELAND AVE
ASHEVILLE NC
28801-4005
US

IV. Provider business mailing address

172 ASHELAND AVE
ASHEVILLE NC
28801-4005
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-7921
  • Fax: 828-254-9487
Mailing address:
  • Phone: 828-254-7921
  • Fax: 828-254-9487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number4837
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: