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NPI Code Detail

MEDICARE: HAMILTON, CLARK, OTERO & ASSOCIATES

MEDICARE: HAMILTON, CLARK, OTERO & ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry8843NC

General Provider Information

NPI Number : 1407150063
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAMILTON, CLARK, OTERO & ASSOCIATES
Provider Business Mailing Address
First Line : 4622 OLEANDER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-5149
Country : US
Telephone Number : 910-399-1127
Fax Number : 910-399-3479
Provider Business Practice Location Address
First Line : 4622 OLEANDER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-5149
Country : US
Telephone Number : 910-399-1127
Fax Number : 910-399-3479
Authorized Official
Title or Position : PART OWNER/DDS
Name : DR. TRISTAN WILLIAM HAMILTON
Credential : MARCH., DDS
Telephone Number : 910-399-1127
Provider Enumeration Date : 12/22/2010
Last Update Date : 12/22/2010

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Directions to “HAMILTON, CLARK, OTERO & ASSOCIATES ” Practice Location

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