Provider Demographics
NPI:1932113321
Name:HORNUNG, GREGORY LEWIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:LEWIS
Last Name:HORNUNG
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 1:4834 SOCIALVILLE FOSTER RD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6826
Mailing Address - Country:US
Mailing Address - Phone:513-228-7801
Mailing Address - Fax:513-228-7802
Practice Address - Street 1:4834 SOCIALVILLE FOSTER RD
Practice Address - Street 2:SUITE 40
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6826
Practice Address - Country:US
Practice Address - Phone:513-228-7801
Practice Address - Fax:513-228-7802
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30016357122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist