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NPI Code Detail

MEDICARE: DR. PAUL A. HAMERSKY D.D.S.

MEDICARE: DR. PAUL A. HAMERSKY D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry4397CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14397OTHERCODENTIST LICENSE NO.

General Provider Information

NPI Number : 1063578086
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL A. HAMERSKY D.D.S.
Provider Business Mailing Address
First Line : 9227 EAST LINCOLN AVE.
Second Line : SUITE #100
City : LONE TREE
State : CO
Zip : 80124-5504
Country : US
Telephone Number : 720-344-2662
Fax Number : 720-344-2663
Provider Business Practice Location Address
First Line : 9227 EAST LINCOLN AVE.
Second Line : SUITE #100
City : LONE TREE
State : CO
Zip : 80124-5504
Country : US
Telephone Number : 720-344-2662
Fax Number : 720-344-2663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 05/06/2015

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