MEDICARE: DR. EDWARD JOHN HORAN DMD

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	DS-024110-L	PA

General Provider Information

NPI Number	:	1811265036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD JOHN HORAN DMD

Provider Business Mailing Address
First Line	:	1825 MURRAY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1605
Country	:	US
Telephone Number	:	412-521-5343
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 MURRAY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1605
Country	:	US
Telephone Number	:	412-521-5343
Fax Number	:

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

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	12/02/2011

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