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General NPI Number Information
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NPI Number | 1235331018
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Entity Type | Individual
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Provider Name | STEPHEN HOROWITZ D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4676 ADMIRALTY WAY 532
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6601
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Country | US
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Telephone | 310-577-5888
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Fax | 310-577-5886
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Provider Business Mailing Address
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Address Line | 6331 RHEA AVE
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City | TARZANA
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State | CA
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Zip | 91335-6834
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Country | US
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Telephone | 310-702-7247
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 46191
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License Number State | CA
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