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Organization

EAST TAYLOR DENTAL PC

Active
Other names
EASTDALE DENTAL GROUP PC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KILLIAN JOSEPH HORNER DDS (OWNER/PRESIDENT)
(334) 271-4600
Entity
Organization

Contact information

Practice address
2201 TAYLOR ROAD, MONTGOMERY, AL 36117-3498
(334) 271-4600
(334) 271-4709
Mailing address
2201 TAYLOR ROAD, MONTGOMERY, AL 36117-3498
(334) 271-4600
(334) 271-4709

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
816933
UNITED CONCORDIA
01
90188
BCBS
AL
Enumeration date
09/06/2006
Last updated
08/22/2020
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