Provider Demographics
NPI:1821294679
Name:HAMMERLEE, WILLIAM DALE (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DALE
Last Name:HAMMERLEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5158 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2489
Mailing Address - Country:US
Mailing Address - Phone:814-868-3647
Mailing Address - Fax:814-864-2715
Practice Address - Street 1:5158 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2489
Practice Address - Country:US
Practice Address - Phone:814-868-3647
Practice Address - Fax:814-864-2715
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024066-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist