MEDICARE: DONALD ANTHONY HINES HHP, D.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1275992299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD ANTHONY HINES HHP, D.D.

Provider Business Mailing Address
First Line	:	5201 S CHUICHU RD
Second Line	:	LOT 18
City	:	CASA GRANDE
State	:	AZ
Zip	:	85193-7717
Country	:	US
Telephone Number	:	520-280-2371
Fax Number	:

Provider Business Practice Location Address
First Line	:	5201 S CHUICHU RD
Second Line	:	LOT 18
City	:	CASA GRANDE
State	:	AZ
Zip	:	85193-7717
Country	:	US
Telephone Number	:	520-280-2371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	02/18/2016

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