Organization
HAMM DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELBY K FUJII (OFFICE ADMINISTRATION)
(541) 673-3355
Entity
Organization
Contact information
Practice address
1313 W HARVARD AVE, ROSEBURG, OR 97471-2838
(541) 673-3355
(541) 673-1533
Mailing address
1313 W HARVARD AVE, ROSEBURG, OR 97471-2838
(541) 673-3355
(541) 673-1533
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226860
—
OR
05
—
500769119
—
OR
Enumeration date
12/01/2020
Last updated
12/01/2020
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