| Bruce A Boretsky Dmd, Llc | |
|
7310 N Lake Dr Suite C Columbus GA 31909-2787 | |
| (706) 653-2600 | |
| (706) 494-1000 |
| Full Name | Bruce A Boretsky Dmd, Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 7310 N Lake Dr, Columbus, Georgia |
| Authorized Official Name and Position | Bruce A Boretsky (PERIODONTIST) |
| Authorized Official Contact | 7066532600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce A Boretsky Dmd, Llc 7310 N Lake Dr Suite C Columbus GA 31909-2787 Ph: (706) 653-2600 | Bruce A Boretsky Dmd, Llc 7310 N Lake Dr Suite C Columbus GA 31909-2787 Ph: (706) 653-2600 |
| NPI Number | 1962614610 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 01/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962614610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DN012109 (Georgia) | Primary |
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