Provider Demographics
NPI:1992967608
Name:CAVOLA, CAMERON FRANK (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:FRANK
Last Name:CAVOLA
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Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5904 SIX FORKS RD
Mailing Address - Street 2:STE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3838
Mailing Address - Country:US
Mailing Address - Phone:919-322-4500
Mailing Address - Fax:919-322-4495
Practice Address - Street 1:5904 SIX FORKS RD
Practice Address - Street 2:STE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3838
Practice Address - Country:US
Practice Address - Phone:919-322-4500
Practice Address - Fax:919-322-4495
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2014-004421223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery