Provider Demographics
NPI:1659722106
Name:HAMILTON, EVAN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:JOSEPH
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7522 HIGHWAY 107
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-4645
Mailing Address - Country:US
Mailing Address - Phone:501-834-4800
Mailing Address - Fax:
Practice Address - Street 1:7522 HIGHWAY 107
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-4645
Practice Address - Country:US
Practice Address - Phone:501-834-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4118122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist