Individual
MITZI L HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2100 MORSE ROAD, SUITE 4655, COLUMBUS, OH 43229
(614) 470-9840
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30022371
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2667305
—
OH
Enumeration date
12/06/2006
Last updated
12/28/2010
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