Provider Demographics
NPI:1639779598
Name:DR CHANDRA C. BROWN HINES, DDS, PLLC
Entity Type:Organization
Organization Name:DR CHANDRA C. BROWN HINES, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:CHICHELLE
Authorized Official - Last Name:BROWN HINES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:983-329-7358
Mailing Address - Street 1:708 S DUKE ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3119
Mailing Address - Country:US
Mailing Address - Phone:984-329-7358
Mailing Address - Fax:
Practice Address - Street 1:708 S DUKE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3119
Practice Address - Country:US
Practice Address - Phone:984-329-7358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental