Provider Demographics
NPI:1902976251
Name:CAMPBELL, DONALD DEL JR (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:DEL
Last Name:CAMPBELL
Suffix:JR
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:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:LAKE CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:56055
Mailing Address - Country:US
Mailing Address - Phone:507-726-2662
Mailing Address - Fax:507-726-2906
Practice Address - Street 1:131 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:LAKE CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:56055
Practice Address - Country:US
Practice Address - Phone:507-726-2662
Practice Address - Fax:507-726-2906
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist