Provider Demographics
NPI:1003052978
Name:BUTCH E. HAMLETT, DDS, PA
Entity Type:Organization
Organization Name:BUTCH E. HAMLETT, DDS, PA
Other - Org Name:SMILE DESIGNS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BUTCH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HAMLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:870-236-2300
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:622 WEST COURT STREET
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450
Mailing Address - Country:US
Mailing Address - Phone:870-236-2300
Mailing Address - Fax:870-236-2304
Practice Address - Street 1:622 WEST COURT STREET
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450
Practice Address - Country:US
Practice Address - Phone:870-236-2300
Practice Address - Fax:870-236-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1982634457OtherBCBS