Provider Demographics
NPI:1134315815
Name:HUMMERT, THOMAS WILLIAM (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:HUMMERT
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 OLD VILLAGE ROAD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3771
Mailing Address - Country:US
Mailing Address - Phone:828-692-5799
Mailing Address - Fax:828-692-9982
Practice Address - Street 1:1718 OLD VILLAGE ROAD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3771
Practice Address - Country:US
Practice Address - Phone:828-692-5799
Practice Address - Fax:828-692-9982
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81441223P0700X
TX221371223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics