Provider Demographics
NPI:1780731174
Name:BORROWDALE, GREOGRY J (DDS)
Entity type:Individual
Prefix:DR
First Name:GREOGRY
Middle Name:J
Last Name:BORROWDALE
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 1:785 HANA WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3885
Mailing Address - Country:US
Mailing Address - Phone:916-983-1100
Mailing Address - Fax:
Practice Address - Street 1:785 HANA WAY STE 203
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3885
Practice Address - Country:US
Practice Address - Phone:916-983-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA340631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice