Healthcare Provider Details

I. General information

NPI: 1447954649
Provider Name (Legal Business Name): HAMMAKER PROSTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9416 S MAIN ST STE 112
PLYMOUTH MI
48170-4147
US

IV. Provider business mailing address

9416 S MAIN ST STE 112
PLYMOUTH MI
48170-4147
US

V. Phone/Fax

Practice location:
  • Phone: 734-453-6840
  • Fax:
Mailing address:
  • Phone: 734-453-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL HAMMAKER
Title or Position: OWNER, PROSTHODONTIST
Credential: DDS, MS
Phone: 734-453-6840