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Individual

SEAN BRIAN HAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
9750 N ORACLE RD APT 17105, ORO VALLEY, AZ 85704-7689
(520) 404-9425
Mailing address
9750 N ORACLE RD APT 17105, ORO VALLEY, AZ 85704-7689
(520) 404-9425

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10567
AZ
122300000X
Dentist
DDS100574
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10567
AZ DENTAL LICENSE
AZ
Enumeration date
08/11/2016
Last updated
11/20/2020
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