Provider Demographics
NPI:1558741769
Name:HAMASAGAR PC
Entity Type:Organization
Organization Name:HAMASAGAR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMASAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-502-7536
Mailing Address - Street 1:22.W.535 BUTTERFIELD RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137
Mailing Address - Country:US
Mailing Address - Phone:630-469-5024
Mailing Address - Fax:
Practice Address - Street 1:22W535 BUTTERFIELD RD
Practice Address - Street 2:SUITE 8
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-6976
Practice Address - Country:US
Practice Address - Phone:704-502-7536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental