Provider Demographics
NPI:1083142483
Name:LI, HORTON SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:HORTON
Middle Name:SCOTT
Last Name:LI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5000 CROSSINGS CIR STE 301
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8591
Mailing Address - Country:US
Mailing Address - Phone:615-754-4444
Mailing Address - Fax:
Practice Address - Street 1:604 S CUMBERLAND ST STE 200
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-4794
Practice Address - Country:US
Practice Address - Phone:615-208-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN104731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry