Provider Demographics
NPI:1457799223
Name:TODD L HAMILTON DDS PA
Entity Type:Organization
Organization Name:TODD L HAMILTON DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:LELAND
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-779-9793
Mailing Address - Street 1:7482 WATERSIDE CROSSING BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-3005
Mailing Address - Country:US
Mailing Address - Phone:704-822-0320
Mailing Address - Fax:704-822-8097
Practice Address - Street 1:7482 WATERSIDE CROSSING BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-3005
Practice Address - Country:US
Practice Address - Phone:704-822-0320
Practice Address - Fax:704-822-8097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty