Organization
POTTSVILLE ORAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY HOROWITZ DDS,MD (PRESIDENT)
(570) 622-9746
Entity
Organization
Contact information
Practice address
2257 W END AVE, POTTSVILLE, PA 17901-1825
(570) 622-9746
(570) 622-3723
Mailing address
2257 W END AVE, POTTSVILLE, PA 17901-1825
(570) 622-9746
(570) 622-3723
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS031220-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11013134
CAQH #
PA
01
—
1649251570
NPI INDIVIDUAL
PA
Enumeration date
08/04/2006
Last updated
06/30/2017
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