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NPI Code Detail

MEDICARE: MR. EDWARD JAMES CAMACHO DDS

MEDICARE:  MR. EDWARD JAMES CAMACHO  DDS
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
1122300000XDentistD12713TX

General Provider Information

NPI Number : 1649493743
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD JAMES CAMACHO DDS
Provider Business Mailing Address
First Line : 16535 HUEBNER RD STE 102
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78248-1676
Country : US
Telephone Number : 210-493-9944
Fax Number : 210-493-9946
Provider Business Practice Location Address
First Line : 16535 HUEBNER RD STE 102
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78248-1676
Country : US
Telephone Number : 210-493-9944
Fax Number : 210-493-9946
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 12/02/2010

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Directions to “ MR. EDWARD JAMES CAMACHO DDS” Practice Location

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