Provider Demographics
NPI:1104078716
Name:ZELEN, CAMILLE J (DDS)
Entity type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:J
Last Name:ZELEN
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-2628
Mailing Address - Country:US
Mailing Address - Phone:218-464-5222
Mailing Address - Fax:
Practice Address - Street 1:1624 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803-2628
Practice Address - Country:US
Practice Address - Phone:218-464-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6796122300000X
MND12746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist