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General NPI Number Information
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NPI Number | 1477363091
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Entity Type | Organization
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Legal Business Name | CLIFTON S. CAMERON, D.D.S. III - LEESVILLE, PLLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 9305 LEESVILLE RD STE 202
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City | RALEIGH
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State | NC
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Zip | 27613-7603
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Country | US
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Telephone | 910-260-5296
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Fax |
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Provider Business Mailing Address
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Address Line | 9305 LEESVILLE RD STE 102
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City | RALEIGH
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State | NC
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Zip | 27613-7603
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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 | CREDENTIALING SPECIALIST
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Name | MARINA RAMIREZ
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Credential |
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Telephone | 301-202-4724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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