Provider Demographics
NPI:1710048988
Name:HAMMOND, NATHAN BOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:BOYD
Last Name:HAMMOND
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 1:17068 W. SAGUARO LN.
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388
Mailing Address - Country:US
Mailing Address - Phone:623-433-9858
Mailing Address - Fax:
Practice Address - Street 1:5750 W THUNDERBIRD RD STE F680
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4693
Practice Address - Country:US
Practice Address - Phone:602-942-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist