Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | DN19199 | FL |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN19199 | FL |
N | 1223X0008X | Oral and Maxillofacial Radiology | D19199 | FL |
NPI | 1649591637 |
---|---|
Provider Name | Dr. Aaron Lyle Campbell |
First Address | Orlando, FL 32801-4931 |
Second Address | Winter Park, FL 32789-1836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 09/06/2016 |