Provider Demographics
NPI:1407252893
Name:OSBEL BORGES DMD PA
Entity Type:Organization
Organization Name:OSBEL BORGES DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OSBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-604-3216
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 940
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-604-3216
Mailing Address - Fax:305-604-3217
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 940
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-604-3216
Practice Address - Fax:305-604-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN192281223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty