Provider Demographics
NPI:1497022362
Name:HAMAM, FADI (RDH)
Entity Type:Individual
Prefix:MR
First Name:FADI
Middle Name:
Last Name:HAMAM
Suffix:
Gender:M
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 N FIELDER RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4697
Mailing Address - Country:US
Mailing Address - Phone:814-462-0007
Mailing Address - Fax:
Practice Address - Street 1:723 N FIELDER RD
Practice Address - Street 2:SUITE E
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4697
Practice Address - Country:US
Practice Address - Phone:814-462-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist