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General NPI Number Information
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NPI Number | 1598154981
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Entity Type | Organization
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Legal Business Name | HORIZON 1 PLLC
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 1000 N CURTIS RD STE 103
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City | BOISE
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State | ID
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Zip | 83706-1345
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Country | US
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Telephone | 208-343-0909
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Fax | 208-343-6282
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Provider Business Mailing Address
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Address Line | 1000 N CURTIS RD STE 103
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City | BOISE
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State | ID
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Zip | 83706-1345
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Country | US
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Telephone | 208-343-0909
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Fax | 208-343-6282
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Authorized Official
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Title or Position | CEO
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Name | DR. COLE W ANDERSON
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Credential | DMD, MS
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Telephone | 208-343-0909
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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 | D4410OS
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License Number State | ID
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