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General NPI Number Information
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NPI Number | 1851590152
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Entity Type | Individual
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Provider Name | MARK AARON CHAMBERS DDS
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 2860 VALENCIA DR STE 101
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7597
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Country | US
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Telephone | 208-524-7055
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Fax | 208-524-7209
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Provider Business Mailing Address
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Address Line | 6950 NE CAMPUS WAY
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City | HILLSBORO
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State | OR
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Zip | 97124
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Country | US
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Telephone | 208-524-7055
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Fax | 208-524-7209
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D-4085
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License Number State | ID
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