Provider Demographics
NPI:1093766917
Name:HORNE, MARK ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDREW
Last Name:HORNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 BRANSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3101
Mailing Address - Country:US
Mailing Address - Phone:615-292-5524
Mailing Address - Fax:615-292-0216
Practice Address - Street 1:2831 BRANSFORD AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3101
Practice Address - Country:US
Practice Address - Phone:615-292-5524
Practice Address - Fax:615-292-0216
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000079971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice