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NPI 1154720167

IndividualActive

Broc Hammon, D.M.D.

NPI 1154720167 · Oral and Maxillofacial Surgery (Dentist) · Scott Afb, IL

Provider details

NPI number: 1154720167
Entity type: Individual
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Credential: D.M.D.
Sex: Male
Sole proprietor: No
License: 019.032972 (IL)

Practice location

310 W Losey St

Scott Afb, IL 62225-5250

Phone: (618) 256-9355

Fax: (618) 256-7018

More IL providers

Mailing address

101 Bodin Cir

Travis Afb, CA 94535

Registry dates

Enumerated: 2014-08-14
Last updated: 2022-02-15

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Broc Hammon, D.M.D. — NPI 1154720167, Scott Afb, IL | NPI Central