Organization
VALLEY FACIAL PLASTICS & ENT, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BURRY DO (PRESIDENT)
(208) 746-0193
Entity
Organization
Contact information
Practice address
330 WARNER DR, LEWISTON, ID 83501-4441
(208) 746-0193
(208) 746-7074
Mailing address
330 WARNER DR, LEWISTON, ID 83501-4441
(208) 746-0193
(208) 746-7074
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002456000
—
ID
05
—
7092091
—
WA
Enumeration date
02/07/2007
Last updated
07/18/2025
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