G. PETE LESEBERG D.M.D.P.A. NPI 1346572435

NPI Information

G. PETE LESEBERG D.M.D.,P.A. is an oral and maxillofacial surgery clinic center in Meridian, ID. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. G. PETE LESEBERG D.M.D.,P.A. NPI is 1346572435. The provider is registered as an organization entity type.

The provider's business location address is:

1550 N CRESTMONT DR
STE G
MERIDIAN, ID
ZIP 83642-184
Phone: (208) 884-0100
Fax: (208) 884-4844

The provider's authorized official is Kamie Lund .
The authorized official title is Office Manager and has the following contact phone number (208) 884-0100.

The enumeration date for this NPI number is 2/1/2010 and was last updated on 2/1/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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