Provider Demographics
NPI:1942643515
Name:HORIZON ORTHODONTICS, P.A
Entity Type:Organization
Organization Name:HORIZON ORTHODONTICS, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-221-8166
Mailing Address - Street 1:14240 HORIZON BLVD # A
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-8582
Mailing Address - Country:US
Mailing Address - Phone:915-852-5060
Mailing Address - Fax:
Practice Address - Street 1:14240 HORIZON BLVD # A
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-8582
Practice Address - Country:US
Practice Address - Phone:915-852-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty