MEDICARE: CRAIG P HORNUNG DMD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1922741206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG P HORNUNG DMD PC

Provider Business Mailing Address
First Line	:	227 MAIN ST
Second Line	:
City	:	ROCKPORT
State	:	MA
Zip	:	01966-2024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	227 MAIN ST
Second Line	:
City	:	ROCKPORT
State	:	MA
Zip	:	01966-2024
Country	:	US
Telephone Number	:	978-546-3020
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CRAIG HORNUNG
Credential	:	DMD
Telephone Number	:	978-314-1836

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	04/18/2022

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