MEDICARE: DR. CAMERON & ASSOCIATES OF FUQUAY, PLLC

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	8369	NC
2	1223G0001X	General Practice Dentistry	8432	NC
3	332BC3200X	Customized Equipment (DME)
4	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1790055044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. CAMERON & ASSOCIATES OF FUQUAY, PLLC

Provider Business Mailing Address
First Line	:	1625 N MAIN ST STE 201
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-5399
Country	:	US
Telephone Number	:	919-977-0627
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 N MAIN ST STE 201
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-5399
Country	:	US
Telephone Number	:	919-977-0627
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HESHAM SAMY ABDELBAKY
Credential	:	DDS
Telephone Number	:	919-977-0627

Provider Enumeration Date	:	01/04/2012
Last Update Date	:	03/29/2022

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