Provider Demographics
NPI:1619741352
Name:HOMETOWN CHILDRENS DENTISTRY LLC
Entity Type:Organization
Organization Name:HOMETOWN CHILDRENS DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-716-8830
Mailing Address - Street 1:1120 JACKSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1722
Mailing Address - Country:US
Mailing Address - Phone:215-716-8830
Mailing Address - Fax:
Practice Address - Street 1:1120 JACKSONVILLE RD
Practice Address - Street 2:
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974-1722
Practice Address - Country:US
Practice Address - Phone:215-716-8830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty