Provider Demographics
NPI:1225203219
Name:HAMMER, LAWRENCE JEROME (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JEROME
Last Name:HAMMER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 EAGLE ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3602
Mailing Address - Country:US
Mailing Address - Phone:973-731-9886
Mailing Address - Fax:973-731-0407
Practice Address - Street 1:509 EAGLE ROCK AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3602
Practice Address - Country:US
Practice Address - Phone:973-731-9886
Practice Address - Fax:973-731-0407
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101045900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist