Stefanie Joy Camm, DDS
Individual provider Active NPI Dentist · Galion, OH
NPI 1861552382 · NPPES record last updated Oct 16, 2012
Key facts
- NPI
- 1861552382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 30.022276 (OH)
- Practice address
- 112 S Market St
Galion, OH 44833-2626 - Phone
- (419) 468-1100
- Fax
- (419) 468-1104
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.022276 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.022276 | OH | Yes |
Addresses
Primary practice location
112 S Market St
Galion, OH 44833-2626
Mailing address
112 S Market St
Galion, OH 44833-2626
Phone (419) 468-1100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100505922 | Medicaid | NV | |
| 3036931 | Medicaid | OH |
Other providers in Galion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2012. 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.