Provider Demographics
NPI:1407550296
Name:ABH DENTAL ENTERPRISES
Entity Type:Organization
Organization Name:ABH DENTAL ENTERPRISES
Other - Org Name:HAMMERBECK DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMERBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-822-8388
Mailing Address - Street 1:985 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:WI
Mailing Address - Zip Code:54162-2701
Mailing Address - Country:US
Mailing Address - Phone:920-822-8388
Mailing Address - Fax:920-822-1735
Practice Address - Street 1:985 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:WI
Practice Address - Zip Code:54162-2701
Practice Address - Country:US
Practice Address - Phone:920-822-8388
Practice Address - Fax:920-822-1735
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABH DENTAL ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-28
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty