Sidow, Boris J
Sidow, Boris J is an sole proprietor health care provider with primary practice located at 3634 Wheeler Road , Augusta GA 30909-6518. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Dentist. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Sidow, Boris J can be contacted via phone (706) 860-8228.Contact Information
Primary practice address
3634 Wheeler Road
Augusta GA 30909-6518
Phone: (706) 860-8228
Fax: (706) 860-7222
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN013478 | Georgia |
| Dental Providers / Dentist | 122300000X | DN013478 | Georgia |
Profile Details
| NPI number | 1588674733 |
|---|---|
| LBN Legal business name | Sidow, Boris J |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Sep 16th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588674733 | NPPES |
| Georgia | MEDICAID | 111331508B |
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