Provider Demographics
NPI:1427215375
Name:HAMPTON DENTAL LLC
Entity Type:Organization
Organization Name:HAMPTON DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LOWERY
Authorized Official - Last Name:BRAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-487-6252
Mailing Address - Street 1:4485 WILLIAM FLYNN HWY
Mailing Address - Street 2:#6
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-1424
Mailing Address - Country:US
Mailing Address - Phone:412-487-6252
Mailing Address - Fax:
Practice Address - Street 1:4485 WILLIAM FLYNN HWY
Practice Address - Street 2:#6
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-1424
Practice Address - Country:US
Practice Address - Phone:412-487-6252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-031022-L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental