Provider Demographics
NPI:1871881805
Name:HAMMOUD, NOOR (DDS)
Entity type:Individual
Prefix:
First Name:NOOR
Middle Name:
Last Name:HAMMOUD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8305 S SAGINAW ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1894
Mailing Address - Country:US
Mailing Address - Phone:810-344-9928
Mailing Address - Fax:810-344-9936
Practice Address - Street 1:8305 S SAGINAW ST
Practice Address - Street 2:SUITE 9
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1894
Practice Address - Country:US
Practice Address - Phone:810-344-9928
Practice Address - Fax:810-344-9936
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist