Provider Demographics
NPI:1033896337
Name:MARC SOELBERG DDS PLLC
Entity Type:Organization
Organization Name:MARC SOELBERG DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SOELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:208-618-8878
Mailing Address - Street 1:151 W 3RD AVE UNIT 102
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-4038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 W 3RD AVE UNIT 102
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4038
Practice Address - Country:US
Practice Address - Phone:208-618-8878
Practice Address - Fax:208-618-8879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental