Provider Demographics
NPI:1366590374
Name:WICHMANN DMD & HAMERSKI DMD PC
Entity type:Organization
Organization Name:WICHMANN DMD & HAMERSKI DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC TREAS
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-843-4280
Mailing Address - Street 1:128 BLACKHAWK RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1289
Mailing Address - Country:US
Mailing Address - Phone:724-843-4280
Mailing Address - Fax:724-843-4445
Practice Address - Street 1:128 BLACKHAWK ROAD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:AL
Practice Address - Zip Code:15010
Practice Address - Country:US
Practice Address - Phone:724-843-4280
Practice Address - Fax:724-843-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DS020439L122300000X
PADS020456L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty