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General NPI Number Information
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NPI Number | 1609880491
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Entity Type | Individual
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Provider Name | CHARLES ROBERT HORIN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 08/25/2007
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Provider Practice Location Address
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Address Line | 606 S 4TH ST
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City | EFFINGHAM
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State | IL
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Zip | 62401-3712
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Country | US
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Telephone | 217-342-6288
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Fax | 217-342-7055
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Provider Business Mailing Address
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Address Line | 1008 CARDINAL DR
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City | EFFINGHAM
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State | IL
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Zip | 62401-3166
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Country | US
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Telephone | 217-342-6288
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Fax | 217-342-7055
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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 |
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License Number State | IL
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