Provider Demographics
NPI:1538790993
Name:HAMMERLIND, AMBER LOUISE (DA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LOUISE
Last Name:HAMMERLIND
Suffix:
Gender:F
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 GEORGIA CT NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-2180
Mailing Address - Country:US
Mailing Address - Phone:616-706-6673
Mailing Address - Fax:
Practice Address - Street 1:717 GEORGIA CT NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-2180
Practice Address - Country:US
Practice Address - Phone:616-706-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant