Provider Demographics
NPI:1265435200
Name:HOROWITZ, FRED L (DMD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:L
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 N TOWN CENTER DR STE 175
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-6310
Mailing Address - Country:US
Mailing Address - Phone:702-990-9002
Mailing Address - Fax:
Practice Address - Street 1:1180 N TOWN CENTER DR STE 175
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6310
Practice Address - Country:US
Practice Address - Phone:702-990-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190175521223G0001X
NV6979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral Practice