Provider Demographics
NPI:1548591050
Name:HUTCHINS, VINICE ENICE (DMD)
Entity Type:Individual
Prefix:DR
First Name:VINICE
Middle Name:ENICE
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:VINICE
Other - Middle Name:ENICE
Other - Last Name:HUTCHINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:3545-1 ST. JOHNS BLUFF RD. S.
Mailing Address - Street 2:SUITE 352
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224
Mailing Address - Country:US
Mailing Address - Phone:904-998-7000
Mailing Address - Fax:904-998-7702
Practice Address - Street 1:2801 SAINT JOHNS BLUFF RD S
Practice Address - Street 2:SUITE 1
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-3761
Practice Address - Country:US
Practice Address - Phone:904-998-7000
Practice Address - Fax:904-998-7702
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18866122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice