Provider Demographics
NPI:1942421706
Name:HAMDAN, PATRICIA M (DMD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:HAMDAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MAIN STREET
Mailing Address - Street 2:SUITE 341
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-880-0202
Mailing Address - Fax:603-882-9041
Practice Address - Street 1:280 MAIN STREET
Practice Address - Street 2:SUITE 341
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-880-0202
Practice Address - Fax:603-882-9041
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30005358Medicaid