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General NPI Number Information
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NPI Number | 1104106996
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Entity Type | Individual
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Provider Name | CAMERON D ANDREW DDS
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Gender | Male
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 1658 OAKLAWN DR STE B
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City | PRESCOTT
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State | AZ
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Zip | 86305-1110
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Country | US
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Telephone | 928-771-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 7696 E KNOTS PASS
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-1904
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Country | US
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Telephone | 208-410-1711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D-4388
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | D011401
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License Number State | AZ
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