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Individual

JASON B HAMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
203 7TH AVE S, NAMPA, ID 83651-3846
(208) 466-8400
(208) 466-8436
Mailing address
203 7TH AVE S, NAMPA, ID 83651-3846
(208) 466-8400
(208) 466-8436

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3819
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010159680
BLUE SHIELD OF ID
ID
01
1927603
UNITED CONCORDIA
PA
01
6N136
BLUE CROSS OF ID
ID
05
807635400
ID
Enumeration date
03/06/2007
Last updated
04/21/2015
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