Grant, Scott William

Grant, Scott William is an sole proprietor health care provider with primary practice located at 2275 S Eagle Rd Ste 140 , Meridian ID 83642-2620. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Grant, Scott William can be contacted via phone (208) 938-3190.

Contact Information

Primary practice address
2275 S Eagle Rd Ste 140 Meridian ID 83642-2620
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D-3981 Idaho

Profile Details

NPI number 1194898767
LBN Legal business name Grant, Scott William
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2006
Last updated Jul 29th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194898767 NPPES
Idaho Other 00001890338 UNITED CONCORDIA
Idaho Other 000010157447 UNITED CONCORDIA
Idaho MEDICAID 807480600 UNITED CONCORDIA
Idaho Other 6P052 UNITED CONCORDIA

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