Provider Demographics
NPI:1306952585
Name:CAMPLIN, GARY DOUGLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:DOUGLAS
Last Name:CAMPLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 N HOWARD AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803
Mailing Address - Country:US
Mailing Address - Phone:308-382-1890
Mailing Address - Fax:308-381-4997
Practice Address - Street 1:908 N HOWARD AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803
Practice Address - Country:US
Practice Address - Phone:308-382-1890
Practice Address - Fax:308-381-4997
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3813122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist