Provider Demographics
NPI:1104068246
Name:HORIZON DENTAL CARE, INC.
Entity type:Organization
Organization Name:HORIZON DENTAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANISH
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-226-8800
Mailing Address - Street 1:2537 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-7031
Mailing Address - Country:US
Mailing Address - Phone:570-226-8800
Mailing Address - Fax:570-226-4939
Practice Address - Street 1:2537 ROUTE 6
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-7031
Practice Address - Country:US
Practice Address - Phone:570-226-8800
Practice Address - Fax:570-226-4939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty