Provider Demographics
NPI:1386479715
Name:HORIZON DENTAL CARE AT STROUDSBURG LLC
Entity type:Organization
Organization Name:HORIZON DENTAL CARE AT STROUDSBURG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSSELYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-541-4144
Mailing Address - Street 1:400 WYOMING AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1238
Mailing Address - Country:US
Mailing Address - Phone:570-541-4144
Mailing Address - Fax:
Practice Address - Street 1:1306 N 5TH ST
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2602
Practice Address - Country:US
Practice Address - Phone:570-421-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty