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NPI Code Detail

MEDICARE: CAMERON STONE SHEPHERD

MEDICARE: CAMERON STONE SHEPHERD
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
1122300000XDentistDN28070FL
2122300000XDentistDEN.00205677CO

General Provider Information

NPI Number : 1790475465
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMERON STONE SHEPHERD
Provider Business Mailing Address
First Line : 4972 E 62ND AVE UNIT B1
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-3253
Country : US
Telephone Number : 303-288-4969
Fax Number :
Provider Business Practice Location Address
First Line : 4972 E 62ND AVE UNIT B1
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-3253
Country : US
Telephone Number : 303-288-4969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2023
Last Update Date : 06/20/2023

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Directions to “ CAMERON STONE SHEPHERD ” Practice Location

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