Richard Whiteman Campbell, DDS

Individual provider Active NPI General Practice Dentistry · Minden, LA

NPI 1366617342 · NPPES record last updated Apr 29, 2008

Key facts

NPI
1366617342
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2797 (LA)
Practice address
714 Goode Ave
Minden, LA 71055-2932
Phone
(318) 377-2745
Fax
(318) 377-2746
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2797LAMDCounselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2797 LA Yes

Addresses

Primary practice location

714 Goode Ave
Minden, LA 71055-2932

Mailing address

714 Goode Ave
Minden, LA 71055-2932
Phone (318) 377-2745

Other providers in Minden, LA

All providers in Minden, LA · General Practice Dentistry in Louisiana

Sources for this page

Verify at the official NPI Registry.