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NPI Code Detail

MEDICARE: DR. DAVID J BORGMEYER D.D.S.

MEDICARE: DR. DAVID J BORGMEYER D.D.S.
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
11223G0001XGeneral Practice Dentistry12680MO

General Provider Information

NPI Number : 1063538551
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J BORGMEYER D.D.S.
Provider Business Mailing Address
First Line : 5914 LEONA ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63116-2919
Country : US
Telephone Number : 314-351-6554
Fax Number : 314-353-4035
Provider Business Practice Location Address
First Line : 5914 LEONA ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63116-2919
Country : US
Telephone Number : 314-351-6554
Fax Number : 314-353-4035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 07/08/2007

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