Provider Demographics
NPI:1417421355
Name:CHERYL L HAMILTON DMD LLC
Entity Type:Organization
Organization Name:CHERYL L HAMILTON DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-777-1127
Mailing Address - Street 1:3684 HIGHWAY 150 STE 9
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9692
Mailing Address - Country:US
Mailing Address - Phone:812-923-1400
Mailing Address - Fax:
Practice Address - Street 1:3684 HIGHWAY 150 STE 9
Practice Address - Street 2:
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:812-923-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental