Provider Demographics
NPI:1700980455
Name:HORN, GESICA TENEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GESICA
Middle Name:TENEL
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 1:400 VILLAGE CENTER DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH OAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55512-7203
Mailing Address - Country:US
Mailing Address - Phone:651-288-3111
Mailing Address - Fax:651-288-3113
Practice Address - Street 1:400 VILLAGE CENTER DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH OAKS
Practice Address - State:MN
Practice Address - Zip Code:55127-7203
Practice Address - Country:US
Practice Address - Phone:651-288-3111
Practice Address - Fax:651-288-3113
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11597122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist