Provider Demographics
NPI:1497748057
Name:HAMILTON, EMORY E (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMORY
Middle Name:E
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 E BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8309
Mailing Address - Country:US
Mailing Address - Phone:541-779-4501
Mailing Address - Fax:541-779-8674
Practice Address - Street 1:2930 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8309
Practice Address - Country:US
Practice Address - Phone:541-779-4501
Practice Address - Fax:541-779-8674
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
ORD39621223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics