Provider Demographics
NPI:1528197019
Name:ARBOR DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:ARBOR DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BORGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-835-5780
Mailing Address - Street 1:9515 N LAMAR BLVD
Mailing Address - Street 2:SUITE 158
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4188
Mailing Address - Country:US
Mailing Address - Phone:512-835-5780
Mailing Address - Fax:512-835-9758
Practice Address - Street 1:9515 N LAMAR BLVD
Practice Address - Street 2:SUITE 158
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4188
Practice Address - Country:US
Practice Address - Phone:512-835-5780
Practice Address - Fax:512-835-9758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty