Individual
KATHRYN HORNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23941 JOHN R RD, HAZEL PARK, MI 48030-1416
(248) 547-2055
Mailing address
23941 JOHN R RD, HAZEL PARK, MI 48030-1416
(248) 547-2055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901601834
MI
390200000X
Student in an Organized Health Care Education/Training Program
2901601834
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/21/2023
Last updated
07/25/2024
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