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General NPI Number Information
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NPI Number | 1013754241
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Entity Type | Individual
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Provider Name | NOAH P HORVAT DDS
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Gender | Male
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Dates
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Enumeration Date | 07/15/2024
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 921 N PINE RIVER ST
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City | ITHACA
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State | MI
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Zip | 48847-1119
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Country | US
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Telephone | 989-875-4721
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 NORTHLAND DR NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-1064
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Country | US
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Telephone | 616-364-9451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901602234
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License Number State | MI
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