Provider Demographics
NPI:1316229347
Name:HAMPTON, MARINA V (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:V
Last Name:HAMPTON
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 1:4310 MORNING STAR DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-8815
Mailing Address - Country:US
Mailing Address - Phone:956-336-9630
Mailing Address - Fax:
Practice Address - Street 1:2050 N BUTLER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-4201
Practice Address - Country:US
Practice Address - Phone:505-327-5057
Practice Address - Fax:505-327-0330
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD4454122300000X
TX274511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice