Provider Demographics
NPI:1871527143
Name:CAMPBELL, ERIC S (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9317 LEESVILLE ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613
Mailing Address - Country:US
Mailing Address - Phone:919-870-8298
Mailing Address - Fax:919-870-8299
Practice Address - Street 1:9317 LEESVILLE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7515
Practice Address - Country:US
Practice Address - Phone:919-870-8298
Practice Address - Fax:919-870-8299
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC73951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics