MEDICARE: DR. MICHAEL JOSEPH HORAN D. D. S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN 8378	FL

General Provider Information

NPI Number	:	1316130974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOSEPH HORAN D. D. S.

Provider Business Mailing Address
First Line	:	507 E JACKSON ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-4904
Country	:	US
Telephone Number	:	813-273-9182
Fax Number	:	813-273-6505

Provider Business Practice Location Address
First Line	:	507 E JACKSON ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-4904
Country	:	US
Telephone Number	:	813-273-9182
Fax Number	:	813-273-6505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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