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General NPI Number Information
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NPI Number | 1114159365
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Entity Type | Organization
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Legal Business Name | JOE S. CAMPBELL, DDSPC
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 48 LAUREL DR
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City | ELBERTON
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State | GA
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Zip | 30635-1842
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Country | US
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Telephone | 706-283-1820
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Fax | 706-283-1824
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Provider Business Mailing Address
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Address Line | 48 LAUREL DR
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City | ELBERTON
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State | GA
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Zip | 30635-1842
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Country | US
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Telephone | 706-283-1820
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Fax | 706-283-1824
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Authorized Official
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Title or Position | BUSINESS ASSISTANT
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Name | LAURIE M VAUGHN
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Credential |
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Telephone | 706-283-1820
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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 | 6720
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License Number State | GA
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