Provider Demographics
NPI:1972987287
Name:BYRON C DESBORDES, DDS, PC
Entity type:Organization
Organization Name:BYRON C DESBORDES, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:C
Authorized Official - Last Name:DESBORDES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-277-0138
Mailing Address - Street 1:3120 LORD BALTIMORE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2663
Mailing Address - Country:US
Mailing Address - Phone:410-277-0138
Mailing Address - Fax:410-277-0139
Practice Address - Street 1:3120 LORD BALTIMORE DR
Practice Address - Street 2:STE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2663
Practice Address - Country:US
Practice Address - Phone:410-277-0138
Practice Address - Fax:410-277-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty