Provider Demographics
NPI:1275698383
Name:HINZ, SAMUEL G
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:G
Last Name:HINZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 OLYMPIC DR NW STE B106
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1769
Mailing Address - Country:US
Mailing Address - Phone:253-851-8880
Mailing Address - Fax:253-858-2783
Practice Address - Street 1:5122 OLYMPIC DR NW STE B106
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1769
Practice Address - Country:US
Practice Address - Phone:253-851-8880
Practice Address - Fax:253-858-2783
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0099291223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery