Provider Demographics
NPI:1447303714
Name:CAMPISANO, MARGARET C (DMD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:C
Last Name:CAMPISANO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9325 NEW LAGRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242
Mailing Address - Country:US
Mailing Address - Phone:502-425-1521
Mailing Address - Fax:502-394-0148
Practice Address - Street 1:9325 NEW LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40242
Practice Address - Country:US
Practice Address - Phone:502-425-1521
Practice Address - Fax:502-394-0148
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice