Provider Demographics
NPI:1689852006
Name:HORNBERGER, BRIAN (DDS MS)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HORNBERGER
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 LONETREE WAY
Mailing Address - Street 2:EAST COUNTY ENDODONTICS
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:925-753-5810
Mailing Address - Fax:925-753-5814
Practice Address - Street 1:3801 LONETREE WAY
Practice Address - Street 2:EAST COUNTY ENDODONTICS
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-753-5810
Practice Address - Fax:925-753-5814
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412631223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics