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General NPI Number Information
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NPI Number | 1427215375
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Entity Type | Organization
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Legal Business Name | HAMPTON DENTAL LLC
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 4485 WILLIAM FLYNN HWY #6
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City | ALLISON PARK
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State | PA
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Zip | 15101-1424
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Country | US
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Telephone | 412-487-6252
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Fax |
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Provider Business Mailing Address
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Address Line | 4485 WILLIAM FLYNN HWY #6
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City | ALLISON PARK
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State | PA
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Zip | 15101-1424
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Country | US
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Telephone | 412-487-6252
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNIFER LOWERY BRAUSER
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Credential | D.M.D.
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Telephone | 412-487-6252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS-031022-L
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License Number State | PA
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