MEDICARE: ALLAN HAMBURG D.D.S., P.C.

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
1	1223G0001X	General Practice Dentistry
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number	:	1114030178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLAN HAMBURG D.D.S., P.C.

Provider Business Mailing Address
First Line	:	26615 OAK RIDGE DR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1968
Country	:	US
Telephone Number	:	281-296-8600
Fax Number	:	281-296-9509

Provider Business Practice Location Address
First Line	:	27866 INTERSTATE 45 N
Second Line	:	C
City	:	CONROE
State	:	TX
Zip	:	77385-8725
Country	:	US
Telephone Number	:	281-681-2700
Fax Number	:	281-296-8498

Authorized Official
Title or Position	:	DIR HR/PROFESSIONAL RELATIONS
Name	:	MARY BONEY
Credential	:
Telephone Number	:	281-296-8600

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	08/29/2007

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Directions to “ALLAN HAMBURG D.D.S., P.C. ” Practice Location

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