Organization
DIANE I HINES DDS PC
Active
Other names
Aesthetic Dental Clinique
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE INGRAM HINES DDS (DENTIST)
(313) 207-5945
Entity
Organization
Contact information
Practice address
21500 W 11 MILE RD, SOUTHFIELD, MI 48076-3843
(248) 358-4000
(248) 358-3190
Mailing address
21500 W 11 MILE RD, SOUTHFIELD, MI 48076-3843
(248) 358-4000
(248) 358-3190
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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