MEDICARE: DR. NATHAN BOYD HAMMOND DDS

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	122300000X	Dentist	7058	AZ

General Provider Information

NPI Number	:	1710048988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN BOYD HAMMOND DDS

Provider Business Mailing Address
First Line	:	17068 W. SAGUARO LN.
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85388
Country	:	US
Telephone Number	:	623-433-9858
Fax Number	:

Provider Business Practice Location Address
First Line	:	5750 W THUNDERBIRD RD STE F680
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4693
Country	:	US
Telephone Number	:	602-942-3299
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	11/01/2011

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