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General NPI Number Information
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NPI Number | 1518063601
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Entity Type | Individual
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Provider Name | RICHARD HARVEY CAMPEAU D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 26776 W 12 MILE RD SUITE 203
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City | SOUTHFIELD
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State | MI
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Zip | 48034-7807
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Country | US
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Telephone | 248-355-3993
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Fax |
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Provider Business Mailing Address
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Address Line | 17040 BIRCHWOOD DR
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City | NORTHVILLE
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State | MI
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Zip | 48168-4421
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Country | US
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Telephone | 248-349-7898
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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 | 10211
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License Number State | MI
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