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General NPI Number Information
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NPI Number | 1821544792
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Entity Type | Organization
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Legal Business Name | CAMERON STEWART DDS LLC
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 860 S 2ND AVE SUITE D
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City | WALLA WALLA
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State | WA
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Zip | 99362-4072
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Country | US
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Telephone | 509-529-3470
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Fax | 509-529-3474
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Provider Business Mailing Address
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Address Line | 860 S 2ND AVE SUITE D
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City | WALLA WALLA
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State | WA
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Zip | 99362-4072
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Country | US
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Telephone | 509-529-3470
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Fax | 509-529-3474
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAMERON STEWART
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Credential | DDS
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Telephone | 509-529-3470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 00006438
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License Number State | WA
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