Provider Demographics
NPI:1417994260
Name:HORLICK, TERRY ROSS (DMD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ROSS
Last Name:HORLICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1061 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5724
Mailing Address - Country:US
Mailing Address - Phone:530-272-9026
Mailing Address - Fax:530-272-1527
Practice Address - Street 1:1061 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5724
Practice Address - Country:US
Practice Address - Phone:530-272-9026
Practice Address - Fax:430-272-1527
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA271481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry