Provider Demographics
NPI:1144511916
Name:HAMMAN, NATHAN REED (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:REED
Last Name:HAMMAN
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:399 SOUTHCREST CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-4790
Mailing Address - Country:US
Mailing Address - Phone:662-349-2196
Mailing Address - Fax:662-349-8349
Practice Address - Street 1:399 SOUTHCREST CT
Practice Address - Street 2:SUITE B
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4790
Practice Address - Country:US
Practice Address - Phone:662-349-2196
Practice Address - Fax:662-349-8349
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3537-101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics