Provider Demographics
NPI:1679313654
Name:CAMERON, MASYN INELL (DDS)
Entity type:Individual
Prefix:DR
First Name:MASYN
Middle Name:INELL
Last Name:CAMERON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 ALICE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-4808
Mailing Address - Country:US
Mailing Address - Phone:225-718-9945
Mailing Address - Fax:
Practice Address - Street 1:1143 CHURCH POINT HWY
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-7692
Practice Address - Country:US
Practice Address - Phone:337-344-3724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA75241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice