Provider Demographics
NPI:1760908446
Name:HAMAD, HAMAD RAFIQ ISMAIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAMAD
Middle Name:RAFIQ ISMAIL
Last Name:HAMAD
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 1:1227 ROCKBRIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3065
Mailing Address - Country:US
Mailing Address - Phone:724-426-2389
Mailing Address - Fax:
Practice Address - Street 1:1227 ROCKBRIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3065
Practice Address - Country:US
Practice Address - Phone:770-746-9277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001668122300000X, 1223G0001X
IL019.031991122300000X
VA0401417077122300000X
GADN1225911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist