Provider Demographics
NPI:1760688691
Name:HORWITZ, FREDERICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 ALLOTT AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-2430
Mailing Address - Country:US
Mailing Address - Phone:818-902-0261
Mailing Address - Fax:
Practice Address - Street 1:6245 ALLOTT AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2430
Practice Address - Country:US
Practice Address - Phone:818-902-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22984122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist