Provider Demographics
NPI:1447476130
Name:TEXER, JR., HENRY (DDS)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:TEXER, JR.
Suffix:
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 1:2757 44TH ST SW
Mailing Address - Street 2:303
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 44TH ST SW
Practice Address - Street 2:303
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
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID10494122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID104940OtherBLUE CROSS & BLUE SHIELD
MI4037321Medicaid