Organization
G. PETE LESEBERG D.M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAMIE LUND (OFFICE MANAGER)
(208) 884-0100
Entity
Organization
Contact information
Practice address
1550 N CRESTMONT DR, STE G, MERIDIAN, ID 83642-2184
(208) 884-0100
(208) 884-4844
Mailing address
1550 N CRESTMONT DR, STE G, MERIDIAN, ID 83642-2184
(208) 884-0100
(208) 884-4844
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
B-3163
ID
Other
Enumeration date
02/01/2010
Last updated
02/01/2010
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