Individual
DR. DANIEL BORDATTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
(505) 368-6360
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
(505) 368-6360
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030685
IL
1223G0001X
General Practice Dentistry
019030685
IL
Other
Enumeration date
06/10/2016
Last updated
09/27/2019
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