Provider Demographics
NPI:1457476822
Name:HAMER, DAVID B (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:HAMER
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 1:2202 NORTH BERKSHIRE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901
Mailing Address - Country:US
Mailing Address - Phone:434-296-0188
Mailing Address - Fax:434-296-0189
Practice Address - Street 1:2202 NORTH BERKSHIRE RD
Practice Address - Street 2:STE 101
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:434-296-0188
Practice Address - Fax:434-296-0189
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010068631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9178601Medicaid