Provider Demographics
NPI:1912123423
Name:HORNER, ANDREW T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:T
Last Name:HORNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 SKILLMAN ST
Mailing Address - Street 2:#126
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-9031
Mailing Address - Country:US
Mailing Address - Phone:214-343-6040
Mailing Address - Fax:214-221-4735
Practice Address - Street 1:9205 SKILLMAN ST
Practice Address - Street 2:#126
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-9031
Practice Address - Country:US
Practice Address - Phone:214-343-6040
Practice Address - Fax:214-221-4735
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice