Provider Demographics
NPI:1063725679
Name:BORDEN, BETH (BETH BORDEN, DDS)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:BORDEN
Suffix:
Gender:F
Credentials:BETH BORDEN, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 NC HIGHWAY 150 W
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9074
Mailing Address - Country:US
Mailing Address - Phone:336-644-2770
Mailing Address - Fax:336-644-2778
Practice Address - Street 1:1017 NC HIGHWAY 150 W
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9074
Practice Address - Country:US
Practice Address - Phone:336-644-2770
Practice Address - Fax:336-644-2778
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice