Provider Demographics
NPI:1619179181
Name:R. LEE HINSON JR DDS PA
Entity Type:Organization
Organization Name:R. LEE HINSON JR DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:R
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-565-0949
Mailing Address - Street 1:9007 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6415
Mailing Address - Country:US
Mailing Address - Phone:501-565-0949
Mailing Address - Fax:501-565-6888
Practice Address - Street 1:5304 MABELVALE PIKE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-1820
Practice Address - Country:US
Practice Address - Phone:501-565-0949
Practice Address - Fax:501-565-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2552261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental