Provider Demographics
NPI:1609911700
Name:LESLIE C. HORN, DMD, PSC
Entity Type:Organization
Organization Name:LESLIE C. HORN, DMD, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-268-4407
Mailing Address - Street 1:3349 TATES CREEK RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3467
Mailing Address - Country:US
Mailing Address - Phone:859-268-4407
Mailing Address - Fax:859-268-9562
Practice Address - Street 1:3349 TATES CREEK RD
Practice Address - Street 2:SUITE 208
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3467
Practice Address - Country:US
Practice Address - Phone:859-268-4407
Practice Address - Fax:859-268-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY66051223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty