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General NPI Number Information
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NPI Number | 1447502380
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Entity Type | Organization
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Legal Business Name | CAMPBELL PLC
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 3300 PRINCESS ANNE RD STE 715
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-2603
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Country | US
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Telephone | 757-301-8465
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 PRINCESS ANNE RD STE 715
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-2603
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER/OWNER
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Name | DR. JASON CAMPBELL
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Credential | D.D.S.
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Telephone | 757-301-8465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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