Provider Demographics
NPI:1033251426
Name:HAMRICK, CLARENCE THOMAS III (DMD)
Entity Type:Individual
Prefix:
First Name:CLARENCE
Middle Name:THOMAS
Last Name:HAMRICK
Suffix:III
Gender:M
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:ONE CHARIS DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615
Mailing Address - Country:US
Mailing Address - Phone:864-271-4330
Mailing Address - Fax:864-271-0196
Practice Address - Street 1:ONE CHARIS DRIVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-271-4330
Practice Address - Fax:864-271-0196
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20291223P0300X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics