| Organization Name: | CAMPBELL FAMILY AND COSMETIC DENTISTRY |
| NPI Number: | 1235495284 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SPENCER C CAMPBELL (DENTIST/OWNER) |
| Mailing Address: | 48 Piedmont Dr Suite 302 Winder |
| State: | GA US |
| Postal Code: | 306808131 |
| Phone Number: | 7708688788 |
| Fax Number: | 7708688781 |
| NPI Enumeration Date: | 04/04/2012 |
| NPI Last Update Date: | 04/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN014117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |