George L Hamm, DMD

Individual provider Active NPI General Practice Dentistry · Dover, PA

NPI 1346319340 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1346319340
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DSO29-247L (PA)
Practice address
74 E Canal St
Dover, PA 17315-1502
Phone
(717) 292-1081
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151201002819 PA Order and Referring Only - Dentist
Practitioner - Dentist
4981904620

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DSO29-247LPAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DSO29-247L PA Yes

Addresses

Primary practice location

74 E Canal St
Dover, PA 17315-1502

Mailing address

74 E Canal St
Dover, PA 17315-1502
Phone (717) 292-1081

Other providers in Dover, PA

All providers in Dover, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.