Healthcare Provider Details

I. General information

NPI: 1609595487
Provider Name (Legal Business Name): BRIANNA BERNADETTE HORNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 08/05/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 PROVIDENCE HWY
NORWOOD MA
02062-5925
US

IV. Provider business mailing address

1939 CAMBRIA DR UNIT B
GREENVILLE NC
27834-0094
US

V. Phone/Fax

Practice location:
  • Phone: 781-451-3135
  • Fax:
Mailing address:
  • Phone: 252-661-0788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10000115
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: