Provider Demographics
NPI:1003931007
Name:HINES, FRANKLIN BANNON III (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:BANNON
Last Name:HINES
Suffix:III
Gender:M
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:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-0388
Mailing Address - Country:US
Mailing Address - Phone:803-315-0916
Mailing Address - Fax:
Practice Address - Street 1:624 CAROLINA BLVD
Practice Address - Street 2:
Practice Address - City:ISLE OF PALMS
Practice Address - State:SC
Practice Address - Zip Code:29451-2117
Practice Address - Country:US
Practice Address - Phone:803-315-0916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC02411223X0400X
SC2180122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics