Basic Information
| Provider Information | |||||||||
| NPI: | 1710949011 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPANA | ||||||||
| FirstName: | LOUIS | ||||||||
| MiddleName: | FRANCIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5100 WINANS RILEY BARRACKS EAST WING | ||||||||
| Address2: | US ARMY DENTAL ACTIVITY | ||||||||
| City: | FORT HUACHUCA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856137040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5205333144 | ||||||||
| FaxNumber: | 5026242966 | ||||||||
| Practice Location | |||||||||
| Address1: | 2240 E. WINROW AVE | ||||||||
| Address2: | US ARMY DENTAL ACTIVITY | ||||||||
| City: | FORT HUACHUCA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856137040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5205333144 | ||||||||
| FaxNumber: | 5205331469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 07/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 18446 | TX | Y | Dental Providers | Dentist | General Practice |
No ID Information.