Provider Demographics
NPI:1427579861
Name:HINES, SETH HARRIS (DMD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:HARRIS
Last Name:HINES
Suffix:
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 1:1851 MACGREGOR DOWNS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5925
Mailing Address - Country:US
Mailing Address - Phone:252-737-7151
Mailing Address - Fax:252-737-7049
Practice Address - Street 1:1161 N ROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3388
Practice Address - Country:US
Practice Address - Phone:252-331-7225
Practice Address - Fax:252-331-7222
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC151150122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist