Campbell, Lisa Michele

Campbell, Lisa Michele is an individual health care provider with primary practice located at 950 County Road 17A W , Avon Park FL 33825-2164. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Campbell, Lisa Michele can be contacted via phone (863) 452-3000.

Contact Information

Primary practice address
950 County Road 17A W Avon Park FL 33825-2164
Phone: (863) 452-3000
Fax: (863) 452-3069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 21248 Texas
Dental Providers / Dentist 122300000X 19960 Ohio
Dental Providers / General Practice 1223G0001X DN 19206 Florida

Profile Details

NPI number 1659594497
LBN Legal business name Campbell, Lisa Michele
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Mar 7th, 2023 - about 2 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 1659594497 NPPES
Ohio Other 7285021 PROVIDER IDENTIFICATION #
Ohio Other DN 19206 PROVIDER IDENTIFICATION #
Ohio MEDICAID 003001500 PROVIDER IDENTIFICATION #

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