Provider Demographics
NPI:1760573877
Name:HINNANT FAMILY DENTISTRY
Entity Type:Organization
Organization Name:HINNANT FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:F
Authorized Official - Last Name:HINNANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-735-2226
Mailing Address - Street 1:2603 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9424
Mailing Address - Country:US
Mailing Address - Phone:919-735-2226
Mailing Address - Fax:
Practice Address - Street 1:2603 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9424
Practice Address - Country:US
Practice Address - Phone:919-735-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty