Provider Demographics
NPI:1912012311
Name:HORNE, SUZANNE J (DDS)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:J
Last Name:HORNE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 COURT ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23868-1812
Mailing Address - Country:US
Mailing Address - Phone:434-848-2323
Mailing Address - Fax:
Practice Address - Street 1:200 COURT ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23868-1812
Practice Address - Country:US
Practice Address - Phone:434-848-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010061821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice