Provider Demographics
NPI:1508952490
Name:HAMBLIN, DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
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 1:5422 W THUNDERBIRD RD
Mailing Address - Street 2:STE 20
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4717
Mailing Address - Country:US
Mailing Address - Phone:480-413-0200
Mailing Address - Fax:480-413-1088
Practice Address - Street 1:3310 S MCCLINTOCK DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5827
Practice Address - Country:US
Practice Address - Phone:480-413-0200
Practice Address - Fax:480-413-1088
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice