Provider Demographics
NPI:1023562055
Name:H. ANDREW HINES, DDS, PA
Entity Type:Organization
Organization Name:H. ANDREW HINES, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:W
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-996-0617
Mailing Address - Street 1:319 S SHARON AMITY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2898
Mailing Address - Country:US
Mailing Address - Phone:704-366-3526
Mailing Address - Fax:704-366-5121
Practice Address - Street 1:319 S SHARON AMITY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2898
Practice Address - Country:US
Practice Address - Phone:704-366-3526
Practice Address - Fax:704-366-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty