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Provider Information for 1689832925

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DR. CAMILO JOSEPH DUARTE D.D.S.

Gender: MALE

Individual NPI: 1689832925

Calendar   Last Updated:  2012-03-19
  Certification Date: 

Details

Name Value
NPI 1689832925
Enumeration Date 2008-05-22
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 5830 HARRISON RD
FREDERICKSBURG, VA 22407-4202
United States

Phone: 540-710-0400 | Fax: 540-693-7373
View Map External Link
Primary Practice Address 5830 HARRISON RD
FREDERICKSBURG, VA 22407-4202
United States

Phone: 540-710-0400 | Fax: 540-693-7373
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice VA 0401412057