Provider Demographics
NPI:1033432737
Name:HAMLING, JEFFERY MICHAEL (DDS, MS)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:MICHAEL
Last Name:HAMLING
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 VALLEY COMMONS DR
Mailing Address - Street 2:STE. E
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6432
Mailing Address - Country:US
Mailing Address - Phone:406-582-1515
Mailing Address - Fax:406-582-1919
Practice Address - Street 1:4055 VALLEY COMMONS DR
Practice Address - Street 2:STE. E
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6432
Practice Address - Country:US
Practice Address - Phone:406-582-1515
Practice Address - Fax:406-582-1919
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1649322777OtherCHIP DENTAL