Provider Demographics
NPI:1962195404
Name:CAMPBELL, DAVID DUANE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DUANE
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 1:2211 DUBLIN RD UNIT 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-2092
Mailing Address - Country:US
Mailing Address - Phone:615-852-8422
Mailing Address - Fax:
Practice Address - Street 1:2475 E 22ND ST # 304
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3221
Practice Address - Country:US
Practice Address - Phone:615-852-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300272041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice