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General NPI Number Information
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NPI Number | 1760123368
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Entity Type | Organization
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Legal Business Name | ANDREW HAMILTON DDS PLLC
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 1414 E CENTRE AVE
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City | PORTAGE
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State | MI
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Zip | 49002-4406
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Country | US
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Telephone | 269-381-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 E CENTRE AVE
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City | PORTAGE
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State | MI
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Zip | 49002-4406
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Country | US
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Telephone | 269-381-7770
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW HAMILTON
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Credential | DDS
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Telephone | 269-381-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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