Provider Demographics
NPI:1558526038
Name:BOREN, AARON NICKOLAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:NICKOLAS
Last Name:BOREN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 NE CAMPUS WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5611
Mailing Address - Country:US
Mailing Address - Phone:503-952-2167
Mailing Address - Fax:503-952-2267
Practice Address - Street 1:6902 SE LAKE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-2148
Practice Address - Country:US
Practice Address - Phone:503-659-0930
Practice Address - Fax:503-654-3846
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist