Provider Demographics
NPI:1427156660
Name:CAMPBELL, ROBERT IAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:IAN
Last Name:CAMPBELL
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 1:408 PORTER STREET
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72342
Mailing Address - Country:US
Mailing Address - Phone:870-338-8365
Mailing Address - Fax:870-338-8366
Practice Address - Street 1:408 PORTER STREET
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342
Practice Address - Country:US
Practice Address - Phone:870-338-8365
Practice Address - Fax:870-338-8366
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2183122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR58154OtherBLUE CROSS BLUE SHIELD
AR813197OtherUNITED CONCORDIA