Provider Demographics
NPI:1558587469
Name:HORNBROOK, DAVID S (DDS, FAACD, FACD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:HORNBROOK
Suffix:
Gender:M
Credentials:DDS, FAACD, FACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 ALVARADO RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3616
Mailing Address - Country:US
Mailing Address - Phone:619-463-7797
Mailing Address - Fax:619-463-1351
Practice Address - Street 1:7777 ALVARADO RD
Practice Address - Street 2:SUITE 210
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-8216
Practice Address - Country:US
Practice Address - Phone:619-463-7797
Practice Address - Fax:619-463-1351
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADK-0344971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice