Provider Demographics
NPI:1356408496
Name:HAMMONS, JEFFERY D (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:D
Last Name:HAMMONS
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 1:4561 STATE ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-5358
Mailing Address - Country:US
Mailing Address - Phone:740-373-2915
Mailing Address - Fax:740-373-4513
Practice Address - Street 1:4561 STATE ROUTE 60
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-5358
Practice Address - Country:US
Practice Address - Phone:740-373-2915
Practice Address - Fax:740-373-4513
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH196771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice