Provider Demographics
NPI:1669157889
Name:HAMMOND, GAINES W III (DMD)
Entity type:Individual
Prefix:DR
First Name:GAINES
Middle Name:W
Last Name:HAMMOND
Suffix:III
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 1:306 BUNCUM DR APT 4215
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2406
Mailing Address - Country:US
Mailing Address - Phone:843-743-5358
Mailing Address - Fax:
Practice Address - Street 1:996 TANNER FORD BLVD
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410-4780
Practice Address - Country:US
Practice Address - Phone:843-483-5947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC104961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice