=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588940928
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. HAMILTON L JONES D.D.S., M.S.D
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2011
-----------------------------------------------------
Last Update Date | 10/31/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1212 BENT OAKS CT SUITE 100
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76210-8061
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-387-0823
-----------------------------------------------------
Fax | 940-381-0308
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1212 BENT OAKS CT SUITE 100
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76210-8061
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-387-0823
-----------------------------------------------------
Fax | 940-381-0308
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. KATHY TUCKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 940-387-0823
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | 8687
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------