Provider Demographics
NPI:1407988710
Name:HAMLIN, DENISE E (DDS)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:E
Last Name:HAMLIN
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 1:209 E GAY ST
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-1840
Mailing Address - Country:US
Mailing Address - Phone:660-747-3171
Mailing Address - Fax:660-747-3171
Practice Address - Street 1:209 E GAY ST
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1840
Practice Address - Country:US
Practice Address - Phone:660-747-3171
Practice Address - Fax:660-747-3171
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS604101223G0001X
MO2006020291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200383970AMedicaid
KS200383970BMedicaid