Provider Demographics
NPI:1689892408
Name:HEINTZ, DENNIS GAINES
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GAINES
Last Name:HEINTZ
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 1:102 N CHOLLA
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85228-9035
Mailing Address - Country:US
Mailing Address - Phone:480-898-0809
Mailing Address - Fax:
Practice Address - Street 1:102 N CHOLLA
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85228-9035
Practice Address - Country:US
Practice Address - Phone:480-898-0809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator