Provider Demographics
NPI:1013137678
Name:HORNING, PHILIP D
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:D
Last Name:HORNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 HUMBOLDT RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9199
Mailing Address - Country:US
Mailing Address - Phone:530-894-5454
Mailing Address - Fax:530-894-2473
Practice Address - Street 1:1660 HUMBOLDT RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-9199
Practice Address - Country:US
Practice Address - Phone:530-894-5454
Practice Address - Fax:530-894-2473
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA278921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice