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General NPI Number Information
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NPI Number | 1336051291
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Entity Type | Organization
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Legal Business Name | CAMELOT ENDODONTICS LTD
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 1255 W EMPIRE ST
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City | FREEPORT
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State | IL
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Zip | 61032-6100
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Country | US
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Telephone | 815-235-1461
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 W EMPIRE ST
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City | FREEPORT
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State | IL
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Zip | 61032-6100
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Country | US
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Telephone | 815-235-1461
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Fax |
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Authorized Official
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Title or Position | VP, PAYOR RELATIONS
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Name | MICHAELA MUNIZ
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Credential |
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Telephone | 469-324-3242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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