Provider Demographics
NPI:1790860690
Name:HORLICK, ROBERT H (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:HORLICK
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 1:5554 RESEDA BLVD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356
Mailing Address - Country:US
Mailing Address - Phone:818-708-1020
Mailing Address - Fax:818-708-9563
Practice Address - Street 1:5554 RESEDA BOULEVARD
Practice Address - Street 2:SUITE 101
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-708-1020
Practice Address - Fax:818-708-9563
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA248021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice