Provider Demographics
NPI:1679585335
Name:P MICHAEL HINE DDS INC
Entity Type:Organization
Organization Name:P MICHAEL HINE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-392-4925
Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:STE 1824
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108
Mailing Address - Country:US
Mailing Address - Phone:415-392-4925
Mailing Address - Fax:415-421-6781
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:STE 1824
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108
Practice Address - Country:US
Practice Address - Phone:415-392-4925
Practice Address - Fax:415-421-6781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:P MICHAEL HINE DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-12
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26997122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty