Provider Demographics
NPI:1851018329
Name:HORN, AMEENAH DANYELL
Entity Type:Individual
Prefix:
First Name:AMEENAH
Middle Name:DANYELL
Last Name:HORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WAYMAN PALMER CT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43620-1929
Mailing Address - Country:US
Mailing Address - Phone:419-508-3348
Mailing Address - Fax:
Practice Address - Street 1:42 WAYMAN PALMER CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1929
Practice Address - Country:US
Practice Address - Phone:419-508-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant