Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2180 | SC |
N | 1223X0400X | Orthodontists | 0241 | SC |
NPI | 1003931007 |
---|---|
Provider Name | Dr. Franklin Bannon Hines III |
First Address | Lexington, SC 29072-2129 |
Second Address | Lexington, SC 29072-2129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |