Provider Demographics
NPI:1063512788
Name:SKINNER, HAMAD CORNELL (DDS)
Entity type:Individual
Prefix:DR
First Name:HAMAD
Middle Name:CORNELL
Last Name:SKINNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 GILES PL
Mailing Address - Street 2:APT. 6H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4309
Mailing Address - Country:US
Mailing Address - Phone:718-884-5835
Mailing Address - Fax:718-884-5835
Practice Address - Street 1:651 W 168TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3703
Practice Address - Country:US
Practice Address - Phone:212-740-1780
Practice Address - Fax:212-543-4507
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048009122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist