Provider Demographics
NPI:1871879866
Name:HIERSCHE, MICHAEL (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HIERSCHE
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 1:227 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-5509
Mailing Address - Country:US
Mailing Address - Phone:530-342-3525
Mailing Address - Fax:530-342-8713
Practice Address - Street 1:227 W 6TH ST
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-5509
Practice Address - Country:US
Practice Address - Phone:530-342-3525
Practice Address - Fax:530-342-8713
Is Sole Proprietor?:No
Enumeration Date:2011-10-23
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL018001822122300000X
CA611141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist