MEDICARE: DR. JAMES HAMILTON VASON D.D.S., PC

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
1	1223G0001X	General Practice Dentistry	9296	GA

General Provider Information

NPI Number	:	1922120401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES HAMILTON VASON D.D.S., PC

Provider Business Mailing Address
First Line	:	3280 HOWELL MILL RD NW STE 339
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-4109
Country	:	US
Telephone Number	:	404-367-9799
Fax Number	:	404-609-9221

Provider Business Practice Location Address
First Line	:	3280 HOWELL MILL RD NW STE 339
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-4109
Country	:	US
Telephone Number	:	404-367-9799
Fax Number	:	404-609-9221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	07/08/2007

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