Provider Demographics
NPI:1912048455
Name:HOROWITZ, IRVING (DMD)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:
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:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08553-0334
Mailing Address - Country:US
Mailing Address - Phone:609-921-1940
Mailing Address - Fax:609-921-1028
Practice Address - Street 1:1330 RT 206
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08553
Practice Address - Country:US
Practice Address - Phone:609-921-1940
Practice Address - Fax:609-921-1028
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI106471223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU26631Medicare UPIN