Provider Demographics
NPI:1023338217
Name:HAMMOND FAMILY DENTISTRY, INC
Entity type:Organization
Organization Name:HAMMOND FAMILY DENTISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-245-5226
Mailing Address - Street 1:10 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7624
Mailing Address - Country:US
Mailing Address - Phone:918-245-5226
Mailing Address - Fax:918-245-7959
Practice Address - Street 1:10 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7624
Practice Address - Country:US
Practice Address - Phone:918-245-5226
Practice Address - Fax:918-245-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK48291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1871683193OtherTYPE 1-INDIVIDUAL NPI