MEDICARE: HAMILTON FAMILY DENTAL, P.A.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0177	OTHER	NJ	DELTA DENTAL PROVIDER
2	807715	OTHER	PA	UNITED CONCORDIA PROVIDER

General Provider Information

NPI Number	:	1326136821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMILTON FAMILY DENTAL, P.A.

Provider Business Mailing Address
First Line	:	3932 BLACK HORSE PIKE
Second Line	:
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-3107
Country	:	US
Telephone Number	:	609-909-1100
Fax Number	:	609-909-9199

Provider Business Practice Location Address
First Line	:	3932 BLACK HORSE PIKE
Second Line	:
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-3107
Country	:	US
Telephone Number	:	609-909-1100
Fax Number	:	609-909-9199

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LUCIE M CARMAN
Credential	:	CDA,RDA
Telephone Number	:	609-909-1100

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/22/2020

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