Provider Demographics
NPI:1396255931
Name:GEORGE L HAMM III
Entity type:Organization
Organization Name:GEORGE L HAMM III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-292-1971
Mailing Address - Street 1:74 E CANAL ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-1502
Mailing Address - Country:US
Mailing Address - Phone:717-292-1971
Mailing Address - Fax:717-332-5862
Practice Address - Street 1:74 E CANAL ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-1502
Practice Address - Country:US
Practice Address - Phone:717-292-1971
Practice Address - Fax:717-332-5862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA029247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty