Provider Demographics
NPI:1386326635
Name:CAMERON, ANGELA M (RDH PHE)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:CAMERON
Suffix:
Gender:F
Credentials:RDH PHE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18523
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-0523
Mailing Address - Country:US
Mailing Address - Phone:775-240-0726
Mailing Address - Fax:
Practice Address - Street 1:13070 STONEY BROOK CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-9243
Practice Address - Country:US
Practice Address - Phone:775-240-0726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3395124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist