Organization
ENT SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER VENTURA MD (PRESIDENT)
(435) 833-9600
Entity
Organization
Contact information
Practice address
2376 NORTH 400 EAST, SUITE 202, TOOELE, UT 84074
(435) 833-9600
Mailing address
2376 NORTH 400 EAST, SUITE 202, TOOELE, UT 84074
(435) 833-9600
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
58686931205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529861509001
—
UT
Enumeration date
11/15/2005
Last updated
09/10/2009
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