Provider Demographics
NPI:1922741206
Name:CRAIG P HORNUNG DMD PC
Entity Type:Organization
Organization Name:CRAIG P HORNUNG DMD PC
Other - Org Name:ROCKPORT FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-314-1836
Mailing Address - Street 1:227 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966-2024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:227 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:MA
Practice Address - Zip Code:01966-2024
Practice Address - Country:US
Practice Address - Phone:978-546-3020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental