Provider Demographics
NPI:1841453750
Name:HAMMES, PETER JEROME (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JEROME
Last Name:HAMMES
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 1:237 FISHER DENTAL CLINIC
Mailing Address - Street 2:2410 SAMPSON ST
Mailing Address - City:GREAT LAKES
Mailing Address - State:IL
Mailing Address - Zip Code:60088
Mailing Address - Country:US
Mailing Address - Phone:847-414-5277
Mailing Address - Fax:
Practice Address - Street 1:3001A SIXTH STREET BLDG 200H 4E
Practice Address - Street 2:NAVAL HEALTH CLINIC GREAT LAKES
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088
Practice Address - Country:US
Practice Address - Phone:847-414-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0276141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice