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General NPI Number Information
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NPI Number | 1073679965
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Entity Type | Individual
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Provider Name | CHRISTOPHER DALE BORDEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 1201 21ST ST
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City | HALEYVILLE
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State | AL
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Zip | 35565-1812
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Country | US
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Telephone | 205-486-3113
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Fax | 205-486-2641
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Provider Business Mailing Address
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Address Line | PO BOX 458 1201 21ST STREET
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City | HALEYVILLE
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State | AL
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Zip | 35565-0458
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Country | US
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Telephone | 205-486-3113
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Fax | 205-486-2641
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5464
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License Number State | AL
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