Provider Demographics
NPI:1982779732
Name:BORCHERT, ERIC K (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:K
Last Name:BORCHERT
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 1:11 NORTH 11TH AVE.
Mailing Address - Street 2:#104
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902
Mailing Address - Country:US
Mailing Address - Phone:509-452-7003
Mailing Address - Fax:509-452-0428
Practice Address - Street 1:11 NORTH 11TH AVE.
Practice Address - Street 2:#104
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-452-7003
Practice Address - Fax:509-452-0428
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000089891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice