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Organization

GREGORY N BORGANELLI DMD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREGORY N BORGANELLI DMD PA (PRESIDENT OF CORPORATION)
(386) 752-8200
Entity
Organization

Contact information

Practice address
875 SW STATE RD 47, LAKE CITY, FL 32025
(386) 752-8200
(386) 752-8209
Mailing address
875 SW STATE RD 47, LAKE CITY, FL 32025
(386) 752-8200
(386) 752-8209

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN12271
FL

Other

Enumeration date
12/03/2007
Last updated
12/03/2007
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