Thomas Owen Horn Jr., D.M.D

Individual provider Active NPI General Practice Dentistry · Philadelphia, MS

NPI 1063585693 · NPPES record last updated May 21, 2013

Key facts

NPI
1063585693
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
3004-97 (MS)
Practice address
247 Byrd Ave N
Philadelphia, MS 39350-3043
Phone
(601) 656-5591
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3004-97MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Horn Family Dental, PLLC Current
since Mar 28, 2021
Accepting new patients

Locations

247 Byrd Ave N
Philadelphia, MS 39350
Phone (601) 656-5591

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3004-97 MS Yes

Addresses

Primary practice location

247 Byrd Ave N
Philadelphia, MS 39350-3043

Mailing address

247 Byrd Ave N
Philadelphia, MS 39350-3043
Phone (601) 656-5591

Other identifiers

IdentifierTypeStateIssuer
09014559MedicaidMS

Other providers in Philadelphia, MS

All providers in Philadelphia, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.