Individual
DR. NATHANIEL A BORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2301 N 36TH ST STE 102, BOISE, ID 83703-5202
(208) 336-8801
(208) 466-5359
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 467-4431
(208) 466-5359
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5101
ID
1223G0001X
General Practice Dentistry
D008311
AZ
Other
Enumeration date
09/13/2011
Last updated
01/28/2020
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