Provider Demographics
NPI:1376650200
Name:MARK A HAMMOCK DDS LTD
Entity Type:Organization
Organization Name:MARK A HAMMOCK DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HAMMOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-942-9013
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0387
Mailing Address - Country:US
Mailing Address - Phone:540-942-9013
Mailing Address - Fax:
Practice Address - Street 1:49 TINKLING SPRING ROAD
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-0387
Practice Address - Country:US
Practice Address - Phone:540-942-9013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty