Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 5345 | OK |
NPI | 1598739591 |
---|---|
Provider Name | Dr. Paul William Hamra |
First Address | Hugo, OK 74743-1820 |
Second Address | Hugo, OK 74743-1820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 08/07/2007 |