Provider Demographics
NPI:1871766261
Name:ROBERT L HORCHOVER DDS PS
Entity type:Organization
Organization Name:ROBERT L HORCHOVER DDS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HORCHOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-770-0260
Mailing Address - Street 1:2101 4TH AVENUE
Mailing Address - Street 2:STE 2330
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2317
Mailing Address - Country:US
Mailing Address - Phone:206-770-0260
Mailing Address - Fax:206-770-0182
Practice Address - Street 1:2101 4TH AVENUE
Practice Address - Street 2:STE 2330
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2317
Practice Address - Country:US
Practice Address - Phone:206-770-0260
Practice Address - Fax:206-770-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00002943261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6271160001Medicare NSC
WA8855301Medicare PIN