Provider Demographics
NPI:1942210802
Name:HORNER, ROBERT MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
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 1:11155 DOLFIELD BLVD
Mailing Address - Street 2:STE. 204
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3259
Mailing Address - Country:US
Mailing Address - Phone:410-902-4110
Mailing Address - Fax:410-902-4113
Practice Address - Street 1:11155 DOLFIELD BLVD
Practice Address - Street 2:STE. 204
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3259
Practice Address - Country:US
Practice Address - Phone:410-902-4110
Practice Address - Fax:410-902-4113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice