Provider Demographics
NPI:1588720304
Name:HORGESHEIMER, JASON J (DDS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:J
Last Name:HORGESHEIMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6287 S REDWOOD RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-6634
Mailing Address - Country:US
Mailing Address - Phone:801-281-8881
Mailing Address - Fax:801-281-8883
Practice Address - Street 1:6287 S REDWOOD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-6634
Practice Address - Country:US
Practice Address - Phone:801-281-8881
Practice Address - Fax:801-281-8883
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3603051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry