Provider Demographics
NPI:1942421367
Name:HAMILTON, CLAYTON MONTGOMERY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:MONTGOMERY
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 1:7121 CHIMNEY CORS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-2113
Mailing Address - Country:US
Mailing Address - Phone:512-345-2170
Mailing Address - Fax:512-345-6356
Practice Address - Street 1:7121 CHIMNEY CORS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-2113
Practice Address - Country:US
Practice Address - Phone:512-345-2170
Practice Address - Fax:512-345-6356
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice