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1184798811
MARK ENSIO BAKER
POCATELLO, ID
NPI
1184798811
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: ID d3016)
Enumeration Date
2006-11-17
Last Update Date
2007-07-08
Business Address
Dr. MARK ENSIO BAKER d.d.s.
165 N 14TH AVE
POCATELLO, ID 83201-4146
Phone number: 208-232-2807
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Mailing Address
Dr. MARK ENSIO BAKER d.d.s.
PO BOX 6033 165 N. 14TH
POCATELLO, ID 83205-6033
Phone number: 208-232-2807
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