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General NPI Number Information
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NPI Number | 1265796007
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Entity Type | Individual
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Provider Name | ROCKY E HORTON DDS
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Gender | Male
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 1322 MAIN ST
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City | ALAMOSA
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State | CO
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Zip | 81101
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Country | US
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Telephone | 719-992-2016
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Fax | 719-992-2028
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Provider Business Mailing Address
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Address Line | 110 E ROUTT AVE
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City | PUEBLO
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State | CO
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Zip | 81004-2117
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Country | US
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Telephone | 719-543-8711
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Fax | 719-543-5340
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10754
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10754
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License Number State | CO
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