Provider Demographics
NPI:1609506773
Name:HORSEY ORTHODONTICS
Entity type:Organization
Organization Name:HORSEY ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GUSTAV
Authorized Official - Middle Name:
Authorized Official - Last Name:HORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:804-672-3030
Mailing Address - Street 1:4106 E PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2734
Mailing Address - Country:US
Mailing Address - Phone:804-672-3030
Mailing Address - Fax:804-672-3131
Practice Address - Street 1:4106 E PARHAM RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2734
Practice Address - Country:US
Practice Address - Phone:804-672-3030
Practice Address - Fax:804-672-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty