Provider Demographics
NPI:1003799784
Name:BORGES DMD PLLC
Entity type:Organization
Organization Name:BORGES DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STALIN
Authorized Official - Middle Name:HENRIQUE
Authorized Official - Last Name:DE SOUZA BORGES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-446-9873
Mailing Address - Street 1:BORGES25DMD@GMAIL.COM
Mailing Address - Street 2:7440 ROUTE US-1/SUITE 104,
Mailing Address - City:ST. AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32095
Mailing Address - Country:US
Mailing Address - Phone:908-446-9572
Mailing Address - Fax:
Practice Address - Street 1:BORGES25DMD@GMAIL.COM
Practice Address - Street 2:7440 ROUTE US-1/SUITE 104,
Practice Address - City:ST. AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32095
Practice Address - Country:US
Practice Address - Phone:908-446-9572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty