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General NPI Number Information
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NPI Number | 1225847486
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Entity Type | Organization
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Legal Business Name | CAMEO DENTAL
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 704 S TEXAS BLVD
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City | WESLACO
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State | TX
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Zip | 78596-7052
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Country | US
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Telephone | 956-793-7533
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 S PALM COURT DR
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City | HARLINGEN
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State | TX
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Zip | 78552-3899
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Country | US
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Telephone | 956-793-7533
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Fax |
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Authorized Official
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Title or Position | DENTIST/MANAGER
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Name | DR. STEPHANIE R JACKSON
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Credential | DDS
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Telephone | 956-793-7533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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