Provider Demographics
NPI:1720004260
Name:HORAN, TERRENCE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:L
Last Name:HORAN
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 1:138 FIDDLERS GRN
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WAITSFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05673-6007
Mailing Address - Country:US
Mailing Address - Phone:802-496-2524
Mailing Address - Fax:802-496-6911
Practice Address - Street 1:138 FIDDLERS GRN
Practice Address - Street 2:UNIT 1
Practice Address - City:WAITSFIELD
Practice Address - State:VT
Practice Address - Zip Code:05673-6007
Practice Address - Country:US
Practice Address - Phone:802-496-2524
Practice Address - Fax:802-496-6911
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT593122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist