Kevin Michael Hamilton, DDS

Individual provider Active NPI General Practice Dentistry · Dequincy, LA

NPI 1306993191 · NPPES record last updated Feb 19, 2014

Key facts

NPI
1306993191
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4965 (LA)
Practice address
202 S. Holly Street
Dequincy, LA 70633
Phone
(337) 786-2146
Fax
(337) 786-2874
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4965LAMDGeneral Practice Dentistry
22986TXMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22986 TX
General Practice Dentistry 1223G0001X 4965 LA Yes

Addresses

Primary practice location

202 S. Holly Street
Dequincy, LA 70633

Mailing address

202 S. Holly Street
Dequincy, LA 70633
Phone (337) 786-2146

Other providers in Dequincy, LA

All providers in Dequincy, LA · General Practice Dentistry in Louisiana

Sources for this page

Verify at the official NPI Registry.