Provider Demographics
NPI:1871805879
Name:CAMPBELL, COLLIN BISHOP (DDS)
Entity type:Individual
Prefix:DR
First Name:COLLIN
Middle Name:BISHOP
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-3518
Mailing Address - Country:US
Mailing Address - Phone:940-668-9000
Mailing Address - Fax:940-668-9001
Practice Address - Street 1:734 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-3518
Practice Address - Country:US
Practice Address - Phone:940-668-9000
Practice Address - Fax:940-668-9001
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX254871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice