Provider Demographics
NPI:1639247695
Name:HAMILTON, JEFFERY JAMES (DMD)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:JAMES
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12870 STROH RANCH CT UNIT 103
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7718
Mailing Address - Country:US
Mailing Address - Phone:303-840-6543
Mailing Address - Fax:
Practice Address - Street 1:12870 STROH RANCH CT
Practice Address - Street 2:SUITE 103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-840-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice