| Grant Dental Group | |
|
6500 W Emerald St Boise ID 83704-8736 | |
| (208) 893-5000 | |
| (208) 922-6057 |
| Full Name | Grant Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 6500 W Emerald St, Boise, Idaho |
| Authorized Official Name and Position | Scott W. Grant (PRESIDENT) |
| Authorized Official Contact | 2088882000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant Dental Group 2275 S Eagle Rd Ste 140 Meridian ID 83642-2620 Ph: (208) 888-2000 | Grant Dental Group 6500 W Emerald St Boise ID 83704-8736 Ph: (208) 893-5000 |
| NPI Number | 1689047904 |
|---|---|
| Provider Enumeration Date | 11/09/2015 |
| Last Update Date | 10/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689047904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 124Q00000X | Dental Hygienist | (* (Not Available)) | Secondary |
| 126800000X | Dental Assistant | (* (Not Available)) | Secondary |
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