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General NPI Number Information
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NPI Number | 1083294920
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Entity Type | Organization
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Legal Business Name | LON HINCKLEY DDS PLLC
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 10160 W 50TH AVE UNIT 1
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-2339
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Country | US
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Telephone | 607-427-6362
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Fax |
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Provider Business Mailing Address
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Address Line | 4943 STATE HIGHWAY 52
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City | DACONO
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State | CO
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Zip | 80514-9100
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Country | US
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Telephone | 607-427-6362
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Fax |
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Authorized Official
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Title or Position | ORAL AND MAXILLOFACIAL SURGEON
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Name | DR. LON HINCKLEY
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Credential | DDS
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Telephone | 607-427-6362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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