Provider Demographics
NPI:1235246836
Name:HORTON, PAUL FRAZIER (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRAZIER
Last Name:HORTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5059
Mailing Address - Country:US
Mailing Address - Phone:863-414-4652
Mailing Address - Fax:
Practice Address - Street 1:4229 SEBRING PARKWAY
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870
Practice Address - Country:US
Practice Address - Phone:863-471-1727
Practice Address - Fax:863-471-1768
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12838122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist