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NPI Code Detail

MEDICARE: DR. TRISTAN WILLIAM HAMILTON D.D.S.

MEDICARE: DR. TRISTAN WILLIAM HAMILTON D.D.S.
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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689804940
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRISTAN WILLIAM HAMILTON D.D.S.
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2009
Last Update Date : 05/22/2013

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