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General NPI Number Information
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NPI Number | 1902285620
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Entity Type | Organization
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Legal Business Name | MICHAEL P CAMPEAU, DDS, PC
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 661 E MAIN ST
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City | FREMONT
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State | MI
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Zip | 49412-9708
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Country | US
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Telephone | 231-924-2320
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Fax | 231-924-1518
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Provider Business Mailing Address
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Address Line | 661 E MAIN ST
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City | FREMONT
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State | MI
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Zip | 49412-9708
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Country | US
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Telephone | 231-924-2320
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Fax | 231-924-1518
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MICHAEL PETER CAMPEAU
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Credential | DDS
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Telephone | 231-924-2320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2901018633
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License Number State | MI
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