Provider Demographics
NPI:1013234145
Name:HAMILTON, MARGARET TISDALE
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:TISDALE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 INDIAN LAKE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6210
Mailing Address - Country:US
Mailing Address - Phone:615-822-8403
Mailing Address - Fax:
Practice Address - Street 1:131 INDIAN LAKE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6210
Practice Address - Country:US
Practice Address - Phone:615-822-8403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000094591223S0112X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist