Provider Demographics
NPI:1952408833
Name:BORRELLI, GINA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIE
Last Name:BORRELLI
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 1:1250 OAKMEAD PKWY STE 114
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4035
Mailing Address - Country:US
Mailing Address - Phone:408-730-4498
Mailing Address - Fax:408-730-8662
Practice Address - Street 1:1250 OAKMEAD PKWY STE 114
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4035
Practice Address - Country:US
Practice Address - Phone:408-730-4498
Practice Address - Fax:408-730-8662
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43759122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist