Provider Demographics
NPI:1003199829
Name:PLAINS EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY PC
Entity Type:Organization
Organization Name:PLAINS EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY PC
Other - Org Name:PLAINS EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-235-1924
Mailing Address - Street 1:350 23RD AVE E STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-7401
Mailing Address - Country:US
Mailing Address - Phone:701-235-1924
Mailing Address - Fax:701-235-6304
Practice Address - Street 1:350 23RD AVE E STE 102
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-7401
Practice Address - Country:US
Practice Address - Phone:701-235-1924
Practice Address - Fax:701-235-6304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND10000207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN717266Medicare PIN
NDI37802Medicare UPIN