Provider Demographics
NPI:1144549387
Name:HORNE, JAIME L (DDS)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:L
Last Name:HORNE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 WATER ST
Mailing Address - Street 2:P.O. BOX 146
Mailing Address - City:ORBISONIA
Mailing Address - State:PA
Mailing Address - Zip Code:17243-9432
Mailing Address - Country:US
Mailing Address - Phone:814-447-5556
Mailing Address - Fax:814-447-5682
Practice Address - Street 1:626 WATER ST
Practice Address - Street 2:
Practice Address - City:ORBISONIA
Practice Address - State:PA
Practice Address - Zip Code:17243-9432
Practice Address - Country:US
Practice Address - Phone:814-447-5556
Practice Address - Fax:814-447-5682
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0382621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice