MEDICARE: THOMAS HUGO HAMILTON JR. DDS

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	7389	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1940554	OTHER	UNITED CONCORDIA
3	9018U	OTHER	BLUE CROSS BLUE SHIELD NC

General Provider Information

NPI Number	:	1861429284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS HUGO HAMILTON JR. DDS

Provider Business Mailing Address
First Line	:	2041 SILAS CREEK PKWY
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-5147
Country	:	US
Telephone Number	:	336-777-0303
Fax Number	:	336-777-3448

Provider Business Practice Location Address
First Line	:	1400 WALTER REED RD
Second Line	:	SUITE 200
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4409
Country	:	US
Telephone Number	:	910-864-9884
Fax Number	:	910-354-1399

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

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