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General NPI Number Information
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NPI Number | 1003799784
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Entity Type | Organization
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Legal Business Name | BORGES DMD PLLC
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | BORGES25DMD@GMAIL.COM 7440 ROUTE US-1/SUITE 104,
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City | ST. AUGUSTINE
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State | FL
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Zip | 32095
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Country | US
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Telephone | 908-446-9572
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Fax |
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Provider Business Mailing Address
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Address Line | BORGES25DMD@GMAIL.COM 7440 ROUTE US-1/SUITE 104,
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City | ST. AUGUSTINE
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State | FL
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Zip | 32095
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Country | US
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Telephone | 908-446-9572
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. STALIN HENRIQUE DE SOUZA BORGES
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Credential | DMD
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Telephone | 908-446-9873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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