Provider Demographics
NPI:1841282639
Name:CAMPBELL, R. CLAIRE (DMD)
Entity type:Individual
Prefix:DR
First Name:R.
Middle Name:CLAIRE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13110 SE SUNNYSIDE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9333
Mailing Address - Country:US
Mailing Address - Phone:503-698-4884
Mailing Address - Fax:971-327-8843
Practice Address - Street 1:13110 SE SUNNYSIDE RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9333
Practice Address - Country:US
Practice Address - Phone:503-698-4884
Practice Address - Fax:971-327-8843
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD71941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice