Healthcare Provider Details

I. General information

NPI: 1871860296
Provider Name (Legal Business Name): MICHELLE L HAMAN DDS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6725 RANGEWOOD DR
COLORADO SPRINGS CO
80918
US

IV. Provider business mailing address

6725 RANGEWOOD DR
COLORADO SPRINGS CO
80918
US

V. Phone/Fax

Practice location:
  • Phone: 719-596-6920
  • Fax: 719-260-7040
Mailing address:
  • Phone: 719-596-6920
  • Fax: 719-260-7040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7156
License Number StateCO

VIII. Authorized Official

Name: DR. MICHELLE L HAMAN
Title or Position: OWNER
Credential: D.D.S
Phone: 719-596-6920