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NPI Code Detail

MEDICARE: ROBERT G. CAMPBELL, D.D.S.

MEDICARE: ROBERT G. CAMPBELL, D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist37793CA

General Provider Information

NPI Number : 1063961142
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT G. CAMPBELL, D.D.S.
Provider Business Mailing Address
First Line : 3960 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-3502
Country : US
Telephone Number : 562-988-0148
Fax Number : 562-988-0257
Provider Business Practice Location Address
First Line : 3960 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-3502
Country : US
Telephone Number : 562-988-0148
Fax Number : 562-988-0257
Authorized Official
Title or Position : OWNER/DENTIST
Name : DR. ROBERT G. CAMPBELL
Credential : DDS
Telephone Number : 562-988-0148
Provider Enumeration Date : 09/29/2016
Last Update Date : 09/29/2016

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