Provider Demographics
NPI:1548407679
Name:HAMILTON & HERRING ORTHODONTICS
Entity Type:Organization
Organization Name:HAMILTON & HERRING ORTHODONTICS
Other - Org Name:DR. DAVID C. HAMILTON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-324-4535
Mailing Address - Street 1:322 10TH AVENUE DR NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2611
Mailing Address - Country:US
Mailing Address - Phone:828-324-4535
Mailing Address - Fax:828-324-8748
Practice Address - Street 1:322 10TH AVENUE DR NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2611
Practice Address - Country:US
Practice Address - Phone:828-324-4535
Practice Address - Fax:828-324-8748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14811223X0400X
NC76131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906413Medicaid