MEDICARE: DR. FRANKLIN BANNON HINES III DMD

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	0241	SC
2	122300000X	Dentist	2180	SC

General Provider Information

NPI Number	:	1003931007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANKLIN BANNON HINES III DMD

Provider Business Mailing Address
First Line	:	PO BOX 388
Second Line	:
City	:	ISLE OF PALMS
State	:	SC
Zip	:	29451-0388
Country	:	US
Telephone Number	:	803-315-0916
Fax Number	:

Provider Business Practice Location Address
First Line	:	624 CAROLINA BLVD
Second Line	:
City	:	ISLE OF PALMS
State	:	SC
Zip	:	29451-2117
Country	:	US
Telephone Number	:	803-315-0916
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	05/22/2023

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