Individual
JENNIFER E HAMMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4915 WASHINGTON AVE STE B, RACINE, WI 53406-4249
(262) 619-1949
Mailing address
4915 WASHINGTON AVE STE B, RACINE, WI 53406-4249
(262) 619-1949
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1003316-16
WI
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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