Provider Demographics
NPI:1588746663
Name:HAMILTON, JULIE RUTH (DDS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:RUTH
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 TIFFANY DR
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1033
Mailing Address - Country:US
Mailing Address - Phone:304-533-6333
Mailing Address - Fax:
Practice Address - Street 1:5411 TIFFANY DR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1033
Practice Address - Country:US
Practice Address - Phone:304-533-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice