Provider Demographics
NPI:1073688107
Name:HAMMOND, FREDERICK WHITE (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:WHITE
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2878 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3872
Mailing Address - Country:US
Mailing Address - Phone:619-298-2200
Mailing Address - Fax:619-298-2250
Practice Address - Street 1:2878 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3872
Practice Address - Country:US
Practice Address - Phone:619-298-2200
Practice Address - Fax:619-298-2250
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA319221223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery