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General NPI Number Information
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NPI Number | 1538223680
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Entity Type | Organization
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Legal Business Name | R DOUGLAS CAMPBELL, DMD, INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2260 OTAY LAKES RD SUITE 110
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City | CHULA VISTA
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State | CA
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Zip | 91915-1005
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Country | US
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Telephone | 619-421-5500
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Fax | 619-656-4320
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Provider Business Mailing Address
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Address Line | 2260 OTAY LAKES RD SUITE 110
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City | CHULA VISTA
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State | CA
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Zip | 91915-1005
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Country | US
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Telephone | 619-421-5500
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Fax | 619-656-4320
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT DOUGLAS CAMPBELL
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Credential | DMD
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Telephone | 619-421-5500
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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 | 40060
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License Number State | CA
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