Provider Demographics
NPI:1760516579
Name:HAMM, MORGAN MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:MICHAEL
Last Name:HAMM
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:W249S3642 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-7364
Mailing Address - Country:US
Mailing Address - Phone:262-542-8382
Mailing Address - Fax:262-542-9602
Practice Address - Street 1:W249S3642 CENTER RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-7364
Practice Address - Country:US
Practice Address - Phone:262-542-8382
Practice Address - Fax:262-542-9602
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33388300OtherBADGER CARE TITLE 19