Provider Demographics
NPI:1396882270
Name:HORN, LESLIE C (DMD)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:C
Last Name:HORN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3349 TATES CREEK RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3467
Mailing Address - Country:US
Mailing Address - Phone:859-268-4404
Mailing Address - Fax:859-268-9562
Practice Address - Street 1:3349 TATES CREEK RD
Practice Address - Street 2:SUITE 208
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3467
Practice Address - Country:US
Practice Address - Phone:859-268-4404
Practice Address - Fax:859-268-9562
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY66051223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics