Provider Demographics
NPI:1962762955
Name:HAMULA ORTHODONTICS
Entity type:Organization
Organization Name:HAMULA ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS, MSD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:HAMULA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:719-487-3737
Mailing Address - Street 1:1860 WOODMOOR DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9093
Mailing Address - Country:US
Mailing Address - Phone:719-488-3737
Mailing Address - Fax:719-488-5971
Practice Address - Street 1:1860 WOODMOOR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9093
Practice Address - Country:US
Practice Address - Phone:719-488-3737
Practice Address - Fax:719-488-5971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5535251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare