Provider Demographics
NPI:1619395415
Name:HINZ, KALA LYNN (DDS, MS)
Entity Type:Individual
Prefix:
First Name:KALA
Middle Name:LYNN
Last Name:HINZ
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 SUPERIOR DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1773
Mailing Address - Country:US
Mailing Address - Phone:507-269-1131
Mailing Address - Fax:507-288-3344
Practice Address - Street 1:2743 SUPERIOR DR NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1773
Practice Address - Country:US
Practice Address - Phone:507-288-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MND13394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program