Individual
DR. LEROY DIMITRIOS HORTON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1901 S UNION AVE, B3008, TACOMA, WA 98405-1702
(253) 572-9777
Mailing address
4810 S ASOTIN ST, TACOMA, WA 98408-4209
(253) 572-3485
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00011048
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5053947
—
WA
Enumeration date
07/20/2007
Last updated
10/05/2007
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