Sidow, Boris J

Sidow, Boris J is an sole proprietor health care provider with primary practice located at 3634 Wheeler Road , Augusta GA 30909-6518. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Dentist. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Sidow, Boris J can be contacted via phone (706) 860-8228.

Contact Information

Primary practice address
3634 Wheeler Road Augusta GA 30909-6518
Phone: (706) 860-8228
Fax: (706) 860-7222
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DN013478 Georgia
Dental Providers / Dentist 122300000X DN013478 Georgia

Profile Details

NPI number 1588674733
LBN Legal business name Sidow, Boris J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2006
Last updated Sep 16th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1588674733 NPPES
Georgia MEDICAID 111331508B

Popular Providers