Borchardt, Michael Gustav

Borchardt, Michael Gustav is an individual health care provider with primary practice located at 571 Cox Rd , Gastonia NC 28054-0632. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Borchardt, Michael Gustav can be contacted via phone (704) 865-7603.

Contact Information

Primary practice address
571 Cox Rd Gastonia NC 28054-0632
Phone: (704) 865-7603
Fax: (704) 865-6411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3749 North Carolina

Profile Details

NPI number 1639289853
LBN Legal business name Borchardt, Michael Gustav
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639289853 NPPES
North Carolina Other 90868 BCBS PROVIDER NUMBER
North Carolina MEDICAID 8990868 BCBS PROVIDER NUMBER

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