Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 19782 | OH |
NPI | 1033323415 |
---|---|
Provider Name | Dr. Brian Hockenberger |
First Address | Norton, OH 44203-5732 |
Second Address | Norton, OH 44203-5732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |