Provider Demographics
NPI:1851825533
Name:MOHORN & ASSOCIATES DDS PLLC
Entity type:Organization
Organization Name:MOHORN & ASSOCIATES DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:BASHAM
Authorized Official - Last Name:PIERCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-663-8586
Mailing Address - Street 1:408 PARKWAY
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1661
Mailing Address - Country:US
Mailing Address - Phone:336-663-8586
Mailing Address - Fax:877-710-7903
Practice Address - Street 1:408 PARKWAY
Practice Address - Street 2:SUITE A-1
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1661
Practice Address - Country:US
Practice Address - Phone:336-663-8586
Practice Address - Fax:877-710-7903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty