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DR. CRAIG ROBERT CAMERON D.D.S.
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1083809917
Individual Registrant:DR. CRAIG ROBERT CAMERON D.D.S.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
12374 STAFFORD STREET RAVENNA, MI 49451-0204 US
Tel: 231-853-6379 Fax: 231-853-2143
Tel: 231-853-6379 Fax: 231-853-2143
Contact information for business:
PO BOX 204 RAVENNA, MI 49451-0204 US
Tel: 231-853-6379 Fax: 231-853-2143
Tel: 231-853-6379 Fax: 231-853-2143
Registration Information:
NPI: 1083809917
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | MI | 13429 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 4544163 | MI | 05 |
