Provider Demographics
NPI:1972182558
Name:BOROWICZ DENTAL PLLC
Entity type:Organization
Organization Name:BOROWICZ DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BOROWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:218-478-4527
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:OGILVIE
Mailing Address - State:MN
Mailing Address - Zip Code:56358-0069
Mailing Address - Country:US
Mailing Address - Phone:320-272-4450
Mailing Address - Fax:
Practice Address - Street 1:206 N HILL AVE
Practice Address - Street 2:
Practice Address - City:OGILVIE
Practice Address - State:MN
Practice Address - Zip Code:56358-4501
Practice Address - Country:US
Practice Address - Phone:218-478-4527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental