Provider Demographics
NPI:1427106459
Name:HINZE, MICHAEL RAY (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RAY
Last Name:HINZE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WEST 4TH ST.
Mailing Address - Street 2:P.O. BOX 481
Mailing Address - City:HALE CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:79041
Mailing Address - Country:US
Mailing Address - Phone:806-839-2484
Mailing Address - Fax:
Practice Address - Street 1:111 WEST 4TH ST.
Practice Address - Street 2:
Practice Address - City:HALE CENTER
Practice Address - State:TX
Practice Address - Zip Code:79041
Practice Address - Country:US
Practice Address - Phone:806-839-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice