Provider Demographics
NPI:1689889362
Name:HORNER, JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HORNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 E PARKVIEW ST
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-3111
Mailing Address - Country:US
Mailing Address - Phone:731-285-2062
Mailing Address - Fax:
Practice Address - Street 1:433 E PARKVIEW ST
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3111
Practice Address - Country:US
Practice Address - Phone:731-285-2062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice