Provider Demographics
NPI:1457449878
Name:HAMILTON, WILLIAM MCCOWN (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MCCOWN
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:MACK
Other - Middle Name:
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2005 WILSON PKWY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-3550
Mailing Address - Country:US
Mailing Address - Phone:931-433-2465
Mailing Address - Fax:931-433-2465
Practice Address - Street 1:2005 WILSON PKWY
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-3550
Practice Address - Country:US
Practice Address - Phone:931-433-2465
Practice Address - Fax:931-433-2465
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice