Provider Demographics
NPI:1609108588
Name:EDWARD R. HOROWITZ, D.M.D.
Entity Type:Organization
Organization Name:EDWARD R. HOROWITZ, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-523-4314
Mailing Address - Street 1:7 WHITTIER PL
Mailing Address - Street 2:SUITE 114
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-1408
Mailing Address - Country:US
Mailing Address - Phone:617-523-4314
Mailing Address - Fax:617-523-4316
Practice Address - Street 1:7 WHITTIER PL
Practice Address - Street 2:SUITE 114
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1408
Practice Address - Country:US
Practice Address - Phone:617-523-4314
Practice Address - Fax:617-523-4316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121891223E0200X
MA115441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty