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General NPI Number Information
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NPI Number | 1811332463
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Entity Type | Organization
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Legal Business Name | HAMMER AND VANZANT FAMILY DENTISTRY PSC
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 2405 RING ROAD
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701
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Country | US
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Telephone | 270-737-8828
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Fax | 270-763-8374
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Provider Business Mailing Address
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Address Line | 2405 RING ROAD
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701
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Country | US
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Telephone | 270-737-8828
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Fax | 270-763-8374
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRIAN CHARLES HAMMER
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Credential | DMD
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Telephone | 270-737-8828
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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 | 7505
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5115
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License Number State | KY
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