Provider Demographics
NPI:1316960727
Name:HAMMERS, GREGORY B (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:B
Last Name:HAMMERS
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 1:206 WALKER AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK MILLS
Mailing Address - State:MN
Mailing Address - Zip Code:56567-4004
Mailing Address - Country:US
Mailing Address - Phone:218-385-3130
Mailing Address - Fax:218-385-9131
Practice Address - Street 1:206 WALKER AVE N
Practice Address - Street 2:
Practice Address - City:NEW YORK MILLS
Practice Address - State:MN
Practice Address - Zip Code:56567-4004
Practice Address - Country:US
Practice Address - Phone:218-385-3130
Practice Address - Fax:218-385-9131
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN046718900Medicaid