Healthcare Provider Details

I. General information

NPI: 1003931007
Provider Name (Legal Business Name): FRANKLIN BANNON HINES III DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 05/22/2023
Certification Date: 05/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 CAROLINA BLVD
ISLE OF PALMS SC
29451-2117
US

IV. Provider business mailing address

PO BOX 388
ISLE OF PALMS SC
29451-0388
US

V. Phone/Fax

Practice location:
  • Phone: 803-315-0916
  • Fax:
Mailing address:
  • Phone: 803-315-0916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0241
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2180
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: