Provider Demographics
NPI:1063578086
Name:HAMERSKY, PAUL A (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:HAMERSKY
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 1:9227 EAST LINCOLN AVE.
Mailing Address - Street 2:SUITE #100
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5504
Mailing Address - Country:US
Mailing Address - Phone:720-344-2662
Mailing Address - Fax:720-344-2663
Practice Address - Street 1:9227 EAST LINCOLN AVE.
Practice Address - Street 2:SUITE #100
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5504
Practice Address - Country:US
Practice Address - Phone:720-344-2662
Practice Address - Fax:720-344-2663
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4397OtherDENTIST LICENSE NO.