Provider Demographics
NPI:1871887570
Name:DRS CAMERON & ROMAN & ASSOC III PA
Entity type:Organization
Organization Name:DRS CAMERON & ROMAN & ASSOC III PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PA OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-755-0800
Mailing Address - Street 1:17300 DALLAS PARKWAY
Mailing Address - Street 2:#1070
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-755-0800
Mailing Address - Fax:972-755-0890
Practice Address - Street 1:2997 HOPE MILLS ROAD
Practice Address - Street 2:SUITE #C
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306
Practice Address - Country:US
Practice Address - Phone:972-755-0800
Practice Address - Fax:972-755-0890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTALONE PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty