Provider Demographics
NPI:1952510273
Name:GAMM, DAVID J (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:GAMM
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 1:1100 N LYNNDALE DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3011
Mailing Address - Country:US
Mailing Address - Phone:920-731-4484
Mailing Address - Fax:920-731-2889
Practice Address - Street 1:1100 N LYNNDALE DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3011
Practice Address - Country:US
Practice Address - Phone:920-731-4484
Practice Address - Fax:920-731-2889
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31501223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics