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Individual

DR. JAMES WESLEY BORENGASSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3510 S 79TH ST STE 100, FORT SMITH, AR 72903-6250
(479) 242-3340
Mailing address
9205 ROSEWOOD DR, FORT SMITH, AR 72903-7060
(479) 242-3340

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3525
AR
1223G0001X
General Practice Dentistry
3525
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5Y464
BLUE CROSS BLUE SHIELD-AR
AR
Enumeration date
08/24/2006
Last updated
03/17/2018
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