Provider Demographics
NPI:1508968090
Name:HOEKZEMA, FREDERICK JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:HOEKZEMA
Suffix:JR
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 1:8454 WALLINWOOD SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-7308
Mailing Address - Country:US
Mailing Address - Phone:616-457-8198
Mailing Address - Fax:
Practice Address - Street 1:4868 LAKE MICHIGAN DR
Practice Address - Street 2:SUITE A
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-8434
Practice Address - Country:US
Practice Address - Phone:616-895-7415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI113101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice