Provider Demographics
NPI:1487756516
Name:CAMPBELL, CHRISTINE SUE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:SUE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:SUE
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS PC
Mailing Address - Street 1:4110 A ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4621
Mailing Address - Country:US
Mailing Address - Phone:402-484-8444
Mailing Address - Fax:402-484-8445
Practice Address - Street 1:4110 A ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4621
Practice Address - Country:US
Practice Address - Phone:402-484-8444
Practice Address - Fax:402-484-8445
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE55491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice