MEDICARE: DR. DAVID JOHN 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
1	1223G0001X	General Practice Dentistry	D14058	MI

General Provider Information

NPI Number	:	1366458879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOHN CAMPBELL D.D.S

Provider Business Mailing Address
First Line	:	7110 HIGHLAND RD
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48383-2851
Country	:	US
Telephone Number	:	248-887-8387
Fax Number	:	248-889-5842

Provider Business Practice Location Address
First Line	:	7110 HIGHLAND RD
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48383-2851
Country	:	US
Telephone Number	:	248-887-8387
Fax Number	:	248-889-5842

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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