Provider Demographics
NPI:1922275718
Name:ADVANCED DENTAL CARE
Entity Type:Organization
Organization Name:ADVANCED DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-533-4060
Mailing Address - Street 1:2 EXECUTIVE BLVD OFC 307
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4166
Mailing Address - Country:US
Mailing Address - Phone:845-533-4060
Mailing Address - Fax:845-357-4077
Practice Address - Street 1:2 EXECUTIVE BLVD OFC 307
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4166
Practice Address - Country:US
Practice Address - Phone:845-533-4060
Practice Address - Fax:845-357-4077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty