Provider Demographics
NPI:1528171238
Name:CAMPBELL, CHRISTOPHER W (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 PALMETTO PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7851
Mailing Address - Country:US
Mailing Address - Phone:803-808-0888
Mailing Address - Fax:803-808-0891
Practice Address - Street 1:216 PALMETTO PARK BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7851
Practice Address - Country:US
Practice Address - Phone:803-808-0888
Practice Address - Fax:803-808-0891
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice