Healthcare Provider Details

I. General information

NPI: 1093231425
Provider Name (Legal Business Name): WALTER GARWOOD HINMAN V DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 S STATE ST
VINELAND NJ
08360-4851
US

IV. Provider business mailing address

70 S STATE ST
VINELAND NJ
08360-4851
US

V. Phone/Fax

Practice location:
  • Phone: 856-205-9500
  • Fax:
Mailing address:
  • Phone: 856-205-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03116700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS041425
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: