Provider Demographics
NPI:1922792134
Name:HAMILTON, MONICA (DMD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 W PINNACLE POINTE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8120
Mailing Address - Country:US
Mailing Address - Phone:479-254-0200
Mailing Address - Fax:
Practice Address - Street 1:5417 W PINNACLE POINTE DR STE 200
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8120
Practice Address - Country:US
Practice Address - Phone:479-254-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26390122300000X
AR4545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist