Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DEN.00202691 | CO |
NPI | 1023475084 |
---|---|
Provider Name | Dr. Andrew Horne |
First Address | Colorado Springs, CO 80920-7502 |
Second Address | Colorado Springs, CO 80920-7502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2016 |
Last Update Date | 03/04/2019 |