Provider Demographics
NPI:1619175486
Name:FREDERICK HORWITZ DDS INC
Entity type:Organization
Organization Name:FREDERICK HORWITZ DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HORWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-885-0636
Mailing Address - Street 1:8363 RESEDA BOULEVARD
Mailing Address - Street 2:SUITE #202
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324
Mailing Address - Country:US
Mailing Address - Phone:818-885-0636
Mailing Address - Fax:818-885-1629
Practice Address - Street 1:8363 RESEDA BOULEVARD
Practice Address - Street 2:SUITE #202
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324
Practice Address - Country:US
Practice Address - Phone:818-885-0636
Practice Address - Fax:818-885-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22984122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty