Individual
DR. LON SAMUEL HINCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4943 STATE HIGHWAY 52 STE 260, DACONO, CO 80514-9108
(607) 427-6362
Mailing address
4943 STATE HIGHWAY 52 STE 260, DACONO, CO 80514-9108
(607) 427-6362
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1548
WY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN-DEN-LIC-18712
MT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN.00204645
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
05/26/2016
Last updated
06/26/2021
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