Provider Demographics
NPI:1699231134
Name:CHRISTOPHER A HAMM DMD PC
Entity type:Organization
Organization Name:CHRISTOPHER A HAMM DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EUBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-947-1219
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:LUCEDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39452-0006
Mailing Address - Country:US
Mailing Address - Phone:601-947-1219
Mailing Address - Fax:601-947-9461
Practice Address - Street 1:16 PLAZA DR
Practice Address - Street 2:
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-6180
Practice Address - Country:US
Practice Address - Phone:601-947-1219
Practice Address - Fax:601-947-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty