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General NPI Number Information
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NPI Number | 1518155746
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Entity Type | Organization
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Legal Business Name | MARK SZENTES P C
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 222 N 2ND ST STE 311
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City | BOISE
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State | ID
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Zip | 83702-6131
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Country | US
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Telephone | 208-343-0907
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Fax | 208-343-6216
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Provider Business Mailing Address
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Address Line | 222 N 2ND ST STE 311
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City | BOISE
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State | ID
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Zip | 83702-6131
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Country | US
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Telephone | 208-343-0907
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Fax | 208-343-6216
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JILL NEBEKER
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Credential |
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Telephone | 208-343-0907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5993
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License Number State | ID
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