G. PETE LESEBERG D.M.D.,P.A.; NPI #1346572435

Contact Information

G. PETE LESEBERG D.M.D.,P.A.

1550 N CRESTMONT DR
STE G
MERIDIAN, ID 83642-2184

Phone: 208-884-0100
Fax: 208-884-4844
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for G. PETE LESEBERG D.M.D.,P.A.

NPI # 1346572435

LBN Legal business name G. PETE LESEBERG D.M.D.,P.A.

Authorized official KAMIE LUND - (OFFICE MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/01/2010

Last updated 02/01/2010 - About 16 years ago

Identifiers

License #

B-3163

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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