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NPI Code Detail

MEDICARE: DR. DAVID BORSKY DDS, MSD

MEDICARE: DR. DAVID BORSKY DDS, MSD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodontics5587-015WI

General Provider Information

NPI Number : 1467478016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID BORSKY DDS, MSD
Provider Business Mailing Address
First Line : 415 E TIMBERLINE DR
Second Line :
City : APPLETON
State : WI
Zip : 54913-7100
Country : US
Telephone Number : 920-733-4619
Fax Number :
Provider Business Practice Location Address
First Line : 545 E JOHNSON ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-2856
Country : US
Telephone Number : 920-924-9090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 07/08/2007

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Directions to “ DR. DAVID BORSKY DDS, MSD” Practice Location

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