Healthcare Provider Details

I. General information

NPI: 1437622792
Provider Name (Legal Business Name): DR. CAMERON & ASSOCIATES OF BRIER CREEK, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7860 BRIER CREEK PKWY STE 100
RALEIGH NC
27617-8903
US

IV. Provider business mailing address

7860 BRIER CREEK PKWY STE 100
RALEIGH NC
27617-8903
US

V. Phone/Fax

Practice location:
  • Phone: 919-977-0627
  • Fax: 919-435-1110
Mailing address:
  • Phone: 919-977-0627
  • Fax: 919-435-1110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN BOES
Title or Position: OWNER
Credential: DDS
Phone: 919-977-0627