Provider Demographics
NPI:1225847486
Name:CAMEO DENTAL
Entity type:Organization
Organization Name:CAMEO DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-793-7533
Mailing Address - Street 1:1702 S PALM COURT DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3899
Mailing Address - Country:US
Mailing Address - Phone:956-793-7533
Mailing Address - Fax:
Practice Address - Street 1:704 S TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7052
Practice Address - Country:US
Practice Address - Phone:956-793-7533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty