Provider Demographics
NPI:1952830531
Name:HORST, MORGAN (DDS)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:HORST
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 1:115 DREW AVE SE STE 202
Mailing Address - Street 2:
Mailing Address - City:MADELIA
Mailing Address - State:MN
Mailing Address - Zip Code:56062-1870
Mailing Address - Country:US
Mailing Address - Phone:507-642-8742
Mailing Address - Fax:
Practice Address - Street 1:5319 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-1604
Practice Address - Country:US
Practice Address - Phone:402-810-9864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND138511223G0001X
NE7415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice