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General NPI Number Information
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NPI Number | 1477832046
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Entity Type | Organization
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Legal Business Name | BENJAMIN S. HORTON DDS PC
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 4141 GLASS RD NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-2512
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Country | US
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Telephone | 319-393-0773
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Fax | 319-294-4423
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Provider Business Mailing Address
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Address Line | 4141 GLASS RD NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-2512
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Country | US
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Telephone | 319-393-0773
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Fax | 319-294-4423
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENJAMIN SPENCER HORTON
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Credential | D.D.S.
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Telephone | 319-393-0773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 08824
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License Number State | IA
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