MEDICARE: EMORY E 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	1223P0300X	Periodontics	D3962	OR

General Provider Information

NPI Number	:	1831308394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMORY E HAMILTON DMD

Provider Business Mailing Address
First Line	:	1201 NE 7TH ST
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1451
Country	:	US
Telephone Number	:	541-479-6356
Fax Number	:	541-479-6515

Provider Business Practice Location Address
First Line	:	1201 NE 7TH ST
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1451
Country	:	US
Telephone Number	:	541-479-6356
Fax Number	:	541-479-6515

Authorized Official
Title or Position	:	OWNER
Name	:	DR. EMORY E HAMILTON
Credential	:	DMD
Telephone Number	:	541-779-4501

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	08/22/2020

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Directions to “EMORY E HAMILTON DMD ” Practice Location

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