Individual
LAVONNE MARIE HAMMELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
218 N PINE ST, HALFWAY, OR 97834
(541) 742-6012
Mailing address
PO BOX 682, HALFWAY, OR 97834-0682
(541) 742-6012
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE60153590
WA
1223G0001X
General Practice Dentistry
Primary
D11056
OR
Other
Enumeration date
08/09/2010
Last updated
07/26/2019
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