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General NPI Number Information
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NPI Number | 1669157889
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Entity Type | Individual
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Provider Name | GAINES W HAMMOND III DMD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 996 TANNER FORD BLVD
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City | HANAHAN
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State | SC
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Zip | 29410-4780
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Country | US
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Telephone | 843-483-5947
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Fax |
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Provider Business Mailing Address
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Address Line | 306 BUNCUM DR APT 4215
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City | MT PLEASANT
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State | SC
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Zip | 29464-2406
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Country | US
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Telephone | 843-743-5358
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10496
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License Number State | SC
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