Provider Demographics
NPI:1992918767
Name:BORER, ROBERT E (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:BORER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SAGEBRUSH TRL
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8102
Mailing Address - Country:US
Mailing Address - Phone:386-676-0705
Mailing Address - Fax:386-677-9248
Practice Address - Street 1:150 SAGEBRUSH TRL
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8102
Practice Address - Country:US
Practice Address - Phone:386-676-0705
Practice Address - Fax:386-677-9248
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156281223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics