Organization
CULBERSON R BOREN DDS PA
Active
Other names
Dentistry For Children
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CULBERSON REEVES BOREN DDS (OWNER/ DOCTOR)
(903) 581-2198
Entity
Organization
Contact information
Practice address
705 E MARSHALL AVE, MEDICAL PLAZA III, LONGVIEW, TX 75601-5573
(903) 581-2198
(903) 581-9571
Mailing address
7916 S BROADWAY AVE, STE150, TYLER, TX 75703-5274
(903) 581-2198
(903) 581-9571
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
13063
TX
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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