MEDICARE: PAUL R HINDER DDS

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	1223G0001X	General Practice Dentistry	DN15567	FL

General Provider Information

NPI Number	:	1760553283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL R HINDER DDS

Provider Business Mailing Address
First Line	:	228 3RD AVE. N.
Second Line	:	SUITE 200
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-7012
Country	:	US
Telephone Number	:	904-247-3074
Fax Number	:	904-247-3078

Provider Business Practice Location Address
First Line	:	228 3RD AVE N
Second Line	:	SUITE 200
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-7013
Country	:	US
Telephone Number	:	904-247-3074
Fax Number	:	904-247-3078

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	11/17/2014

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