Provider Demographics
NPI:1588145395
Name:HAMILTON AND WHITECOTTON ORTHODONTICS
Entity type:Organization
Organization Name:HAMILTON AND WHITECOTTON ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-822-0320
Mailing Address - Street 1:7482 WATERSIDE CROSSING BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-3007
Mailing Address - Country:US
Mailing Address - Phone:704-822-0320
Mailing Address - Fax:704-822-8097
Practice Address - Street 1:7482 WATERSIDE CROSSING BLVD STE 201
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-3007
Practice Address - Country:US
Practice Address - Phone:704-822-0320
Practice Address - Fax:704-822-8097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8993484Medicaid