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General NPI Number Information
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NPI Number | 1417268731
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Entity Type | Individual
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Provider Name | CAMERON BLAIR DDS
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Gender | Male
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Dates
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Enumeration Date | 07/01/2010
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 388 BETHANY RD
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City | SUNNYVALE
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State | TX
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Zip | 75182-6210
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Country | US
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Telephone | 310-877-1664
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Fax |
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Provider Business Mailing Address
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Address Line | 4809 N BELT LINE RD STE 107
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City | MESQUITE
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State | TX
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Zip | 75150-3101
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Country | US
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Telephone | 696-076-6194
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8983
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6118
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28051
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 28051
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License Number State | TX
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