Provider Demographics
NPI:1285795161
Name:HAMILTON, ANDREW MATHIS (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MATHIS
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1310 OLD 63 S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6078
Mailing Address - Country:US
Mailing Address - Phone:573-449-0749
Mailing Address - Fax:573-815-1022
Practice Address - Street 1:1310 OLD 63 S
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6078
Practice Address - Country:US
Practice Address - Phone:573-449-0749
Practice Address - Fax:573-815-1022
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO0158271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice