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General NPI Number Information
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NPI Number | 1932309069
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Entity Type | Individual
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Provider Name | MICHELLE LYNN HAMILTON DMD, PHD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 1 VA CTR
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City | AUGUSTA
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State | ME
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Zip | 04330-6719
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Country | US
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Telephone | 617-529-2261
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Fax |
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Provider Business Mailing Address
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Address Line | 17 TRACY COVE CIR
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City | ROME
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State | ME
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Zip | 04963-3609
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Country | US
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Telephone | 617-529-2261
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 053565
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License Number State | NY
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