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NPI Code Detail

MEDICARE: MR. MARK AARON CHAMBERS DDS

MEDICARE: MR. MARK AARON CHAMBERS DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD-4085ID

General Provider Information

NPI Number : 1851590152
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK AARON CHAMBERS DDS
Provider Business Mailing Address
First Line : 6950 NE CAMPUS WAY
Second Line :
City : HILLSBORO
State : OR
Zip : 97124
Country : US
Telephone Number : 208-524-7055
Fax Number : 208-524-7209
Provider Business Practice Location Address
First Line : 2860 VALENCIA DR STE 101
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83404-7597
Country : US
Telephone Number : 208-524-7055
Fax Number : 208-524-7209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2007
Last Update Date : 05/07/2015

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