Provider Demographics
NPI:1023230240
Name:HAMPTON, THOMAS ALAN (DMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALAN
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ALAN
Other - Middle Name:
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4741 ALTAMA AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520
Mailing Address - Country:US
Mailing Address - Phone:912-262-1081
Mailing Address - Fax:912-262-9492
Practice Address - Street 1:4741 ALTAMA AVENUE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-262-1081
Practice Address - Fax:912-262-9492
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA10896122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist