Provider Demographics
NPI:1629224555
Name:BORZEMSKY, GEORGE EUGENE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EUGENE
Last Name:BORZEMSKY
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 1:65 DRIVE IN RD
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1548
Mailing Address - Country:US
Mailing Address - Phone:207-834-1151
Mailing Address - Fax:
Practice Address - Street 1:65 DRIVE IN RD
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1548
Practice Address - Country:US
Practice Address - Phone:207-834-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI013479001223G0001X
ME29621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice