Provider Demographics
NPI:1942368527
Name:HORN, NATALIE ANN (DDS)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:HORN
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 1:1582 CHARITY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HUGER
Mailing Address - State:SC
Mailing Address - Zip Code:29450-9541
Mailing Address - Country:US
Mailing Address - Phone:843-544-5345
Mailing Address - Fax:
Practice Address - Street 1:49 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-1248
Practice Address - Country:US
Practice Address - Phone:734-369-9300
Practice Address - Fax:734-529-7246
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010173131223G0001X
SC95741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2901017313OtherSTATE LICENSE NUMBER
MI2901017313OtherSTATE LICENSE NUMBER