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General NPI Number Information
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NPI Number | 1861408916
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Entity Type | Individual
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Provider Name | LARRY A CAMERON DDS
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 GALVIN RD N
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City | BELLEVUE
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State | NE
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Zip | 68005-4852
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Country | US
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Telephone | 402-239-1234
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Fax | 402-293-9364
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Provider Business Mailing Address
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Address Line | 201 GALVIN RD N
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City | BELLEVUE
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State | NE
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Zip | 68005-4852
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Country | US
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Telephone | 402-293-1234
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Fax | 402-293-9364
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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 | 4837
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License Number State | NE
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