Provider Demographics
NPI:1437215720
Name:DRS BORKMAN & KOVALCHICK LLC
Entity Type:Organization
Organization Name:DRS BORKMAN & KOVALCHICK LLC
Other - Org Name:DRS BORKMAN AND KOVALCHICK
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-695-5100
Mailing Address - Street 1:1517 W PATRICK ST
Mailing Address - Street 2:SUITE B-7
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9063
Mailing Address - Country:US
Mailing Address - Phone:301-695-5100
Mailing Address - Fax:
Practice Address - Street 1:1517 W PATRICK ST
Practice Address - Street 2:SUITE B-7
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9063
Practice Address - Country:US
Practice Address - Phone:301-695-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07589122300000X
MD11887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty