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General NPI Number Information
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NPI Number | 1255063772
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Entity Type | Individual
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Provider Name | KEVIN T BORIE DMD
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Gender | Male
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 1348 E HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-4241
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Country | US
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Telephone | 954-719-4799
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S BISCAYNE BLVD APT 2416
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City | MIAMI
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State | FL
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Zip | 33131-5334
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Country | US
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Telephone | 205-937-9733
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN27113
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License Number State | FL
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