Provider Demographics
NPI:1376869248
Name:CHILDRENS DENTISTRY JAMES F COLLETTE DDS & DAVID N. HAMILTON DDS
Entity Type:Organization
Organization Name:CHILDRENS DENTISTRY JAMES F COLLETTE DDS & DAVID N. HAMILTON DDS
Other - Org Name:DENTISTRY FOR KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-585-5437
Mailing Address - Street 1:3911 W 27TH AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-2483
Mailing Address - Country:US
Mailing Address - Phone:509-585-5437
Mailing Address - Fax:
Practice Address - Street 1:3911 W 27TH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-2483
Practice Address - Country:US
Practice Address - Phone:509-585-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
603-007-7271223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA603-007-727OtherUBI