Provider Demographics
NPI:1811908981
Name:HAMILTON, NANCY JANE (DDS)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JANE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 BAYARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1212
Mailing Address - Country:US
Mailing Address - Phone:651-690-3177
Mailing Address - Fax:
Practice Address - Street 1:1516 W LAKE ST
Practice Address - Street 2:SUITE 302
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2554
Practice Address - Country:US
Practice Address - Phone:612-822-1484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND91381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice