MEDICARE: MELISSA A HAMILTON DMD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	21128	MA

General Provider Information

NPI Number	:	1730167826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA A HAMILTON DMD

Provider Business Mailing Address
First Line	:	35 SUMMER ST
Second Line	:	SUITE 102
City	:	TAUNTON
State	:	MA
Zip	:	02780-3469
Country	:	US
Telephone Number	:	508-880-8860
Fax Number	:	508-880-8873

Provider Business Practice Location Address
First Line	:	MA35 SUMMER ST
Second Line	:	SUITE 102
City	:	TAUNTON
State	:	MA
Zip	:	02780-3469
Country	:	US
Telephone Number	:	508-880-8860
Fax Number	:	508-880-8873

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	04/24/2012

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