Provider Demographics
NPI:1760859011
Name:SINO, KATIE ELLEN (DDS)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ELLEN
Last Name:SINO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6134 WHITE HORSE RD
Mailing Address - Street 2:STE C
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-3837
Mailing Address - Country:US
Mailing Address - Phone:864-295-2744
Mailing Address - Fax:864-295-2760
Practice Address - Street 1:6134 WHITE HORSE RD
Practice Address - Street 2:STE C
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-3837
Practice Address - Country:US
Practice Address - Phone:864-295-2744
Practice Address - Fax:864-295-2760
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD.8634 GD1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice