Healthcare Provider Details

I. General information

NPI: 1720909518
Provider Name (Legal Business Name): DR. CAMERON & ASSOCIATES V ONE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 STONECROP DR
WILMINGTON NC
28412-0108
US

IV. Provider business mailing address

2029 STONECROP DR
WILMINGTON NC
28412-0108
US

V. Phone/Fax

Practice location:
  • Phone: 910-218-8858
  • Fax:
Mailing address:
  • Phone: 910-218-8858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: KIM DAVIS
Title or Position: RCM DIRECTOR
Credential:
Phone: 703-568-5773