Provider Demographics
NPI:1912124587
Name:HAMMONS, STEVEN GLENN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GLENN
Last Name:HAMMONS
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 1:811 BLAIR RD
Mailing Address - Street 2:
Mailing Address - City:OLIVER SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37840-2846
Mailing Address - Country:US
Mailing Address - Phone:865-435-4876
Mailing Address - Fax:
Practice Address - Street 1:508 SCARBORO LN
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7379
Practice Address - Country:US
Practice Address - Phone:865-482-5117
Practice Address - Fax:865-481-3504
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-37691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice