Individual
HILLARY J HOMBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6135 SISSONVILLE DR, CHARLESTON, WV 25312-9444
(304) 984-1576
(304) 984-1565
Mailing address
104 ALEX LN, CHARLESTON, WV 25304-2952
(304) 734-2040
(304) 734-2047
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3870
WV
122300000X
Dentist
3970
WV
122300000X
Dentist
IN PROCESS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810018626
—
WV
Enumeration date
04/23/2009
Last updated
05/21/2020
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