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Individual

DR. JOHN ELLIS HORNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2802 W WALKER ST, BRECKENRIDGE, TX 76424-4000
(254) 559-7215
(254) 559-5725
Mailing address
2802 W WALKER ST, BRECKENRIDGE, TX 76424-4000
(254) 559-7215
(254) 559-5725

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11717
TX
1223G0001X
General Practice Dentistry
11717
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008977302
TX
Enumeration date
11/22/2005
Last updated
10/01/2012
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