Provider Demographics
NPI:1245416783
Name:HIRSCH, HENRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:HIRSCH
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 1:37450 GARFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3657
Mailing Address - Country:US
Mailing Address - Phone:586-286-9060
Mailing Address - Fax:586-286-9065
Practice Address - Street 1:37450 GARFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3657
Practice Address - Country:US
Practice Address - Phone:586-286-9060
Practice Address - Fax:586-286-9065
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010111691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice