Provider Demographics
NPI:1811926082
Name:BOROFSKY, MARCY STORCHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARCY
Middle Name:STORCHAN
Last Name:BOROFSKY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4703 ROLLING RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-3344
Mailing Address - Country:US
Mailing Address - Phone:248-770-3883
Mailing Address - Fax:
Practice Address - Street 1:25882 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-9822
Practice Address - Country:US
Practice Address - Phone:888-833-8441
Practice Address - Fax:888-330-4331
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901013720122300000X
NY052548122300000X
PADS036753122300000X
MA21529122300000X
CT009558122300000X
DCDEN1000517122300000X
RIDEN02921122300000X
VT016-0002217122300000X
NJDI02315800122300000X
NH03529122300000X
MD13640122300000X
KS60411122300000X
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3413194Medicaid