Provider Demographics
NPI:1053569087
Name:HAMILTON DENTAL ASSOCIATES OF LEHIGH VALLEY,LLC
Entity type:Organization
Organization Name:HAMILTON DENTAL ASSOCIATES OF LEHIGH VALLEY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SMITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-435-2550
Mailing Address - Street 1:1144 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1042
Mailing Address - Country:US
Mailing Address - Phone:610-435-2550
Mailing Address - Fax:610-351-7451
Practice Address - Street 1:1144 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1042
Practice Address - Country:US
Practice Address - Phone:610-435-2550
Practice Address - Fax:610-351-7451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029262L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008914870001Medicaid