Provider Demographics
NPI:1457449936
Name:HAMBLIN, JAMES WALTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WALTER
Last Name:HAMBLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8730 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1584
Mailing Address - Country:US
Mailing Address - Phone:219-972-3309
Mailing Address - Fax:
Practice Address - Street 1:8730 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1584
Practice Address - Country:US
Practice Address - Phone:219-972-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007995122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist