Provider Demographics
NPI:1386792414
Name:HAMMOND, PAUL B (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:B
Last Name:HAMMOND
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 1:162 HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08091-1807
Mailing Address - Country:US
Mailing Address - Phone:856-767-7766
Mailing Address - Fax:856-767-6761
Practice Address - Street 1:162 HADDON AVE
Practice Address - Street 2:
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091-1807
Practice Address - Country:US
Practice Address - Phone:856-767-7766
Practice Address - Fax:856-767-6761
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI018766001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice