Provider Demographics
NPI:1326102567
Name:ERIC J HOMZE DDS
Entity Type:Organization
Organization Name:ERIC J HOMZE DDS
Other - Org Name:DESERT VALLEY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOMZE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-575-0777
Mailing Address - Street 1:300 HWY 95 A SO
Mailing Address - Street 2:SUITE 110 BLDG A
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408
Mailing Address - Country:US
Mailing Address - Phone:775-575-0777
Mailing Address - Fax:775-575-1336
Practice Address - Street 1:300 HWY 95 A SO
Practice Address - Street 2:SUITE 110 BLDG A
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408
Practice Address - Country:US
Practice Address - Phone:775-575-0777
Practice Address - Fax:775-575-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty