Provider Demographics
NPI:1588839880
Name:HORVATH, GARY P (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:P
Last Name:HORVATH
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E BLACKSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-2607
Mailing Address - Country:US
Mailing Address - Phone:864-587-8000
Mailing Address - Fax:864-587-7337
Practice Address - Street 1:212 E BLACKSTOCK RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-2607
Practice Address - Country:US
Practice Address - Phone:864-587-8000
Practice Address - Fax:864-587-7337
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2992, 4081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics