Individual
LAURELYN BORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2001 UNION ST, SUITE 385, SAN FRANCISCO, CA 94123-4114
(415) 441-9760
Mailing address
820 MISSION AVE APT 1, SAN RAFAEL, CA 94901-3250
(415) 457-1397
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H2463
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133069
DELTA DENTAL LICENSE NO.
CA
01
—
H02463
MEDICAL PROVIDER NUMBER
CA
01
—
H2463
RDH LICENSE #
CA
Enumeration date
05/11/2007
Last updated
07/08/2007
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