MEDICARE: DR. JOSEPH R. HORNE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS021325L	PA

General Provider Information

NPI Number	:	1396902755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH R. HORNE DMD

Provider Business Mailing Address
First Line	:	1097 NORTH AVE
Second Line	:
City	:	MILLVALE
State	:	PA
Zip	:	15209-2255
Country	:	US
Telephone Number	:	412-821-1333
Fax Number	:	412-821-1333

Provider Business Practice Location Address
First Line	:	1097 NORTH AVE
Second Line	:
City	:	MILLVALE
State	:	PA
Zip	:	15209-2255
Country	:	US
Telephone Number	:	412-821-1333
Fax Number	:	412-821-1333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	05/21/2008

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