Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 9429 | TN |
NPI | 1124081997 |
---|---|
Provider Name | Richard Horwat |
First Address | Nashville, TN 37205-1405 |
Second Address | Nashville, TN 37205-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 24/07/2012 |