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General NPI Number Information
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NPI Number | 1063655009
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Entity Type | Individual
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Provider Name | DAQUANT N HORNBEAK (DDS)
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Gender | Male
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 4000 MITCHELLVILLE RD STE B426
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City | BOWIE
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State | MD
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Zip | 20716-3159
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Country | US
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Telephone | 240-334-2930
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Fax | 240-334-2931
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Provider Business Mailing Address
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Address Line | 4000 MITCHELLVILLE RD STE B426
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City | BOWIE
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State | MD
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Zip | 20716-3159
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Country | US
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Telephone | 240-334-2930
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Fax | 240-334-2931
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14435
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License Number State | MD
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