Campbell, Herman Jackson

Campbell, Herman Jackson is an sole proprietor health care provider with primary practice located at Hwy 160 & Mp 394.3 , Kayenta AZ 86033. He recently has only one registered license in Dental Providers / Dental Public Health, which is considered as his primary health care specialty. Campbell, Herman Jackson can be contacted via phone (928) 697-4000.

Contact Information

Primary practice address
Hwy 160 & Mp 394.3 Kayenta AZ 86033
Phone: (928) 697-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X 014958 Missouri

Profile Details

NPI number 1427159474
LBN Legal business name Campbell, Herman Jackson
Credentials DDS, MPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Jan 7th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427159474 NPPES
Indiana Other 12009731A PROFESSIONAL LICENSE
Indiana Other DN010881 PROFESSIONAL LICENSE
Indiana Other 7181 PROFESSIONAL LICENSE
Indiana Other 014958 PROFESSIONAL LICENSE

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