Provider Demographics
NPI:1306988225
Name:HORN, DONALD JOHN (DMD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOHN
Last Name:HORN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 KEYSTONE RD
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688
Mailing Address - Country:US
Mailing Address - Phone:727-942-5700
Mailing Address - Fax:
Practice Address - Street 1:2605 KEYSTONE RD
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34688
Practice Address - Country:US
Practice Address - Phone:727-942-5700
Practice Address - Fax:727-942-0300
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN143131223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics