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General NPI Number Information
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NPI Number | 1588788970
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Entity Type | Individual
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Provider Name | ALISON DAMARODAS CAMPBELL DDS
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 1103 RIVERY BLVD STE 140
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City | GEORGETOWN
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State | TX
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Zip | 78628-3034
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Country | US
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Telephone | 512-864-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 RIVERY BLVD STE 140
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City | GEORGETOWN
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State | TX
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Zip | 78628-3034
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Country | US
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Telephone | 512-864-9595
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 24814
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License Number State | TX
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