MEDICARE: DR. ROBERT E BORER D.M.D.

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
1	1223E0200X	Endodontics	DN15628	FL

General Provider Information

NPI Number	:	1992918767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT E BORER D.M.D.

Provider Business Mailing Address
First Line	:	150 SAGEBRUSH TRL
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-8102
Country	:	US
Telephone Number	:	386-676-0705
Fax Number	:	386-677-9248

Provider Business Practice Location Address
First Line	:	150 SAGEBRUSH TRL
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-8102
Country	:	US
Telephone Number	:	386-676-0705
Fax Number	:	386-677-9248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	06/29/2016

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