Healthcare Provider Details

I. General information

NPI: 1215864590
Provider Name (Legal Business Name): CALEB BORLAND DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 MAIN ST
QUINTER KS
67752-9526
US

IV. Provider business mailing address

314 MAIN ST
QUINTER KS
67752-9526
US

V. Phone/Fax

Practice location:
  • Phone: 785-754-2441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number62319
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: