Individual
DR. MISTY RENE' HORN-BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1301 SUNSET DR, SUITE 6, JOHNSON CITY, TN 37604-7906
(423) 283-8830
Mailing address
1301 SUNSET DR, SUITE 6, JOHNSON CITY, TN 37604-7906
(423) 283-8830
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8728
TN
Other
Enumeration date
07/23/2007
Last updated
01/09/2008
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