Provider Demographics
NPI:1275825473
Name:HORNFELD, RON (DMD)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:
Last Name:HORNFELD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6454
Mailing Address - Country:US
Mailing Address - Phone:212-875-8195
Mailing Address - Fax:212-580-6891
Practice Address - Street 1:125 W 79TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6454
Practice Address - Country:US
Practice Address - Phone:212-875-8195
Practice Address - Fax:212-580-6891
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041701122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist