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General NPI Number Information
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NPI Number | 1730118043
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Entity Type | Individual
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Provider Name | DAVID ALEX CAMPBELL D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3003 S FLORIDA AVE SUITE 201
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City | LAKELAND
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State | FL
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Zip | 33803-4050
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Country | US
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Telephone | 863-687-9227
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Fax | 863-687-2813
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Provider Business Mailing Address
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Address Line | 5207 HIGHLANDS LAKEVIEW LOOP
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City | LAKELAND
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State | FL
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Zip | 33813-5059
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Country | US
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Telephone | 863-607-4979
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN14269
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License Number State | FL
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