Provider Demographics
NPI:1457106874
Name:BORA, PRANIT VASANT (BDS, MDS, MSD)
Entity type:Individual
Prefix:DR
First Name:PRANIT
Middle Name:VASANT
Last Name:BORA
Suffix:
Gender:M
Credentials:BDS, MDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35454 RAVINE BLVD # 23206
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2467
Mailing Address - Country:US
Mailing Address - Phone:205-587-4025
Mailing Address - Fax:
Practice Address - Street 1:35454 RAVINE BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2467
Practice Address - Country:US
Practice Address - Phone:205-587-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2952000868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist