Provider Demographics
NPI:1407886823
Name:HAMILTON, CHERYL L (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:L
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3684 HIGHWAY 150
Mailing Address - Street 2:SUITE 9
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119
Mailing Address - Country:US
Mailing Address - Phone:812-923-1400
Mailing Address - Fax:
Practice Address - Street 1:3684 HIGHWAY 150
Practice Address - Street 2:SUITE 9
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9692
Practice Address - Country:US
Practice Address - Phone:812-923-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010660A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice