Provider Demographics
NPI:1073824744
Name:PIERCE SR, SENNETT AMES (DO)
Entity Type:Individual
Prefix:DR
First Name:SENNETT
Middle Name:AMES
Last Name:PIERCE SR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:330 WARNER DR
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-4441
Mailing Address - Country:US
Mailing Address - Phone:208-746-0193
Mailing Address - Fax:208-746-7074
Practice Address - Street 1:330 WARNER DR
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-4441
Practice Address - Country:US
Practice Address - Phone:208-746-0193
Practice Address - Fax:208-746-7074
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018748207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery