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General NPI Number Information
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NPI Number | 1679313654
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Entity Type | Individual
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Provider Name | MASYN INELL CAMERON DDS
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Gender | Female
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 1143 CHURCH POINT HWY
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City | RAYNE
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State | LA
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Zip | 70578-7692
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Country | US
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Telephone | 337-344-3724
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Fax |
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Provider Business Mailing Address
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Address Line | 411 ALICE DR
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City | LAFAYETTE
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State | LA
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Zip | 70503-4808
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Country | US
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Telephone | 225-718-9945
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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 | 7524
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License Number State | LA
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