Individual
DR. MICHAEL HAMMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3855 AVOCADO BLVD, SUITE 200, LA MESA, CA 91941-7382
(619) 670-4018
(619) 670-4039
Mailing address
3855 AVOCADO BLVD, SUITE 200, LA MESA, CA 91941-7382
(619) 670-4018
(619) 670-4039
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
CA25533
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
953782397
INTERNAL REVENUE SERVICE
CA
Enumeration date
05/31/2012
Last updated
05/17/2026
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