Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101018748 | MI |
NPI | 1073824744 |
---|---|
Provider Name | Dr. Sennett Ames Pierce Sr |
First Address | Lewiston, ID 83501-4441 |
Second Address | Lewiston, ID 83501-4441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2010 |
Last Update Date | 18/06/2015 |