Provider Demographics
NPI:1679737449
Name:HINEBAUGH III, HARRY WARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:WARD
Last Name:HINEBAUGH III
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 E WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3969
Mailing Address - Country:US
Mailing Address - Phone:610-543-0222
Mailing Address - Fax:610-892-8958
Practice Address - Street 1:1260 E WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3969
Practice Address - Country:US
Practice Address - Phone:610-543-0222
Practice Address - Fax:610-892-8958
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS22098-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist