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General NPI Number Information
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NPI Number | 1366590374
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Entity Type | Organization
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Legal Business Name | WICHMANN DMD & HAMERSKI DMD PC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 128 BLACKHAWK ROAD
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City | BEAVER FALLS
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State | AL
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Zip | 15010
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Country | US
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Telephone | 724-843-4280
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Fax | 724-843-4445
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Provider Business Mailing Address
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Address Line | 128 BLACKHAWK RD
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City | BEAVER FALLS
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State | PA
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Zip | 15010-1289
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Country | US
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Telephone | 724-843-4280
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Fax | 724-843-4445
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Authorized Official
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Title or Position | SEC TREAS
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Name | DR. LINDA J HAMERSKI
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Credential | DMD
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Telephone | 724-843-4280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS020439L
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS020456L
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License Number State | PA
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