Roy Campbell, RDA
Individual provider Active NPI Dental Hygienist · Fort Bragg, CA
NPI 1477046027 · NPPES record last updated Jun 8, 2018
Key facts
- NPI
- 1477046027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 12967 (CA)
- Practice address
- 205 South St
Fort Bragg, CA 95437-5540 - Phone
- (707) 861-4088
- NPI assigned
- Jun 8, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 12967 | CA | Yes |
Addresses
Primary practice location
205 South St
Fort Bragg, CA 95437-5540
Mailing address
205 South St
Fort Bragg, CA 95437-5540
Phone (707) 861-4088
Other providers in Fort Bragg, CA
- Lindsay Burkhardt
- Myra Connel Burt
- Peter K Burtis
- Jayne Susan Bush
- Donna Maria Call
- Sonia Castro
- Kathleen L Cave
- Kimberly Jill Celeri
- Cep America - Neurology PC
- Anne Marie Cesario
All providers in Fort Bragg, CA · Dental Hygienist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.