Provider Demographics
NPI:1609149343
Name:HOMZE, ERIC J (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:HOMZE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ERIC
Other - Middle Name:J
Other - Last Name:HOMZE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7900 MEADOW VISTA DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2001
Mailing Address - Country:US
Mailing Address - Phone:775-575-0777
Mailing Address - Fax:775-575-1336
Practice Address - Street 1:300 US HIGHWAY 95A S
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9721
Practice Address - Country:US
Practice Address - Phone:775-575-0777
Practice Address - Fax:775-575-1336
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV29831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice