Provider Demographics
NPI:1326285941
Name:HORIZON DENTAL OF PAYSON
Entity Type:Organization
Organization Name:HORIZON DENTAL OF PAYSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-465-3111
Mailing Address - Street 1:107 S 500 W
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2029
Mailing Address - Country:US
Mailing Address - Phone:801-465-3111
Mailing Address - Fax:801-465-3777
Practice Address - Street 1:107 S 500 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2029
Practice Address - Country:US
Practice Address - Phone:801-465-3111
Practice Address - Fax:801-465-3777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON DENTAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty