Organization
PEDIATRIC DENTAL ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON R HORNE D.D.S (OWNER)
(903) 758-6406
Entity
Organization
Contact information
Practice address
5 DOCTOR CIR, LONGVIEW, TX 75605-5050
(903) 758-6406
(903) 758-8116
Mailing address
5 DOCTOR CIR, LONGVIEW, TX 75605-5050
(903) 758-6406
(903) 758-8116
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
13954
TX
1223P0221X
Pediatric Dentistry
Primary
18784
TX
1223P0221X
Pediatric Dentistry
20796
TX
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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