Provider Demographics
NPI:1730281809
Name:HORN, TEENA FREEMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TEENA
Middle Name:FREEMAN
Last Name:HORN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:TEENA
Other - Middle Name:FREEMAN
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 604
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MS
Mailing Address - Zip Code:38851
Mailing Address - Country:US
Mailing Address - Phone:662-456-9992
Mailing Address - Fax:662-456-9093
Practice Address - Street 1:327 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MS
Practice Address - Zip Code:38851
Practice Address - Country:US
Practice Address - Phone:662-456-9992
Practice Address - Fax:662-456-9093
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2012831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00060268Medicaid