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General NPI Number Information
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NPI Number | 1407593734
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Entity Type | Organization
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Legal Business Name | BORO DENTISTRY
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 4503 US 62
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City | HILLSBORO
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State | OH
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Zip | 45133-6377
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Country | US
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Telephone | 937-393-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 4503 US 62
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City | HILLSBORO
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State | OH
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Zip | 45133-6377
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Country | US
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Telephone | 937-393-4343
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAITLYN PHILLIPS
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Credential | D.D.S.
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Telephone | 513-649-1073
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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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