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General NPI Number Information
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NPI Number | 1316226731
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Entity Type | Individual
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Provider Name | RICHARD JEREMY HAMMOND DMD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 1301 FOUNTAIN PARK CIR
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City | BRUNSWICK
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State | GA
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Zip | 31520
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Country | US
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Telephone | 912-254-4450
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Fax | 912-266-8696
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Provider Business Mailing Address
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Address Line | 1301 FOUNTAIN PARK CIR
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City | BRUNSWICK
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State | GA
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Zip | 31520-4860
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Country | US
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Telephone | 302-983-9707
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | RES3043
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License Number State | OH
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