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
Phone: (208) 938-3190
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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