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General NPI Number Information
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NPI Number | 1477797314
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER D. BORDEN, DMD PC
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Dates
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Enumeration Date | 04/22/2009
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Last Update Date | 04/22/2009
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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
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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 | PRESIDENT
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Name | DR. CHRISTOPHER D BORDEN
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Credential | DMD
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Telephone | 205-486-3113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 5464
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License Number State | AL
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