Provider Demographics
NPI:1801131651
Name:HORTON, HEATHER (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 CURVE CREST BLVD W
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6069
Mailing Address - Country:US
Mailing Address - Phone:651-439-1966
Mailing Address - Fax:651-439-7555
Practice Address - Street 1:1395 CURVE CREST BLVD W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6069
Practice Address - Country:US
Practice Address - Phone:651-439-1966
Practice Address - Fax:651-439-7555
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND131701223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics