Provider Demographics
NPI:1710945845
Name:BORGIA, ANTHONY THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:THOMAS
Last Name:BORGIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LONG POND RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2642
Mailing Address - Country:US
Mailing Address - Phone:508-747-4441
Mailing Address - Fax:508-746-3558
Practice Address - Street 1:110 LONG POND RD
Practice Address - Street 2:SUITE 124
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2642
Practice Address - Country:US
Practice Address - Phone:508-747-4441
Practice Address - Fax:508-746-3558
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150391223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics