Provider Demographics
NPI:1760553283
Name:HINDER, PAUL R (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:HINDER
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 1:228 3RD AVE. N.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-7012
Mailing Address - Country:US
Mailing Address - Phone:904-247-3074
Mailing Address - Fax:904-247-3078
Practice Address - Street 1:228 3RD AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-7013
Practice Address - Country:US
Practice Address - Phone:904-247-3074
Practice Address - Fax:904-247-3078
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN155671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice