Provider Demographics
NPI:1336103696
Name:DR HENRY TEXER JR DDS PC
Entity Type:Organization
Organization Name:DR HENRY TEXER JR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEXER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:616-538-1050
Mailing Address - Street 1:2757 44 ST SW
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-4192
Mailing Address - Country:US
Mailing Address - Phone:616-538-1050
Mailing Address - Fax:616-831-6712
Practice Address - Street 1:2757 44 ST SW
Practice Address - Street 2:SUITE 303
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-4192
Practice Address - Country:US
Practice Address - Phone:616-538-1050
Practice Address - Fax:616-831-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID104940OtherBCBS
MI4037321Medicaid