Provider Demographics
NPI:1053500744
Name:HORTON, JULIE S (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:S
Last Name:HORTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 BARONY ST STE 7
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-3145
Mailing Address - Country:US
Mailing Address - Phone:843-761-7110
Mailing Address - Fax:843-761-2913
Practice Address - Street 1:421 BARONY ST
Practice Address - Street 2:SUITE 7
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3145
Practice Address - Country:US
Practice Address - Phone:843-761-7110
Practice Address - Fax:843-761-2913
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice