Provider Demographics
NPI:1275036733
Name:HAMARNAH DDS PLLC
Entity Type:Organization
Organization Name:HAMARNAH DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMARNAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-248-2585
Mailing Address - Street 1:1034 GATEWAY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8360
Mailing Address - Country:US
Mailing Address - Phone:561-249-2585
Mailing Address - Fax:561-318-8040
Practice Address - Street 1:1034 GATEWAY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8360
Practice Address - Country:US
Practice Address - Phone:561-249-2585
Practice Address - Fax:561-318-8040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23000261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental