MEDICARE: DR. ROBERT LESLIE HORTON JR. DDS

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	1223G0001X	General Practice Dentistry	DS2317	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841289048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LESLIE HORTON JR. DDS

Provider Business Mailing Address
First Line	:	PO BOX 1027
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-1027
Country	:	US
Telephone Number	:	731-584-4560
Fax Number	:	731-584-8267

Provider Business Practice Location Address
First Line	:	180 HOSPITAL DR
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-1618
Country	:	US
Telephone Number	:	731-584-4560
Fax Number	:	731-584-8267

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	07/09/2007

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