MEDICARE: DR. FRED L HOROWITZ D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	019017552	IL
2	122300000X	Dentist	6979	NV

General Provider Information

NPI Number	:	1265435200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRED L HOROWITZ D.M.D.

Provider Business Mailing Address
First Line	:	1180 N TOWN CENTER DR STE 175
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-6310
Country	:	US
Telephone Number	:	702-990-9002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 N TOWN CENTER DR STE 175
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-6310
Country	:	US
Telephone Number	:	702-990-9002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	05/22/2025

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