Provider Demographics
NPI:1023382538
Name:STEVEN R HINZE, DDS, PC
Entity Type:Organization
Organization Name:STEVEN R HINZE, DDS, PC
Other - Org Name:GREAT PLAIN ORAL SURGERY AND IMPLANT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HINZE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, OMS
Authorized Official - Phone:308-532-5283
Mailing Address - Street 1:921 S WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6079
Mailing Address - Country:US
Mailing Address - Phone:308-532-5283
Mailing Address - Fax:308-532-4770
Practice Address - Street 1:921 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6079
Practice Address - Country:US
Practice Address - Phone:308-532-5283
Practice Address - Fax:308-532-4770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE42521223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE095109Medicare PIN