Grin Pllc | |
2685 Channing Way Idaho Falls ID 83404-7518 | |
(208) 522-1164 | |
Not Available |
Full Name | Grin Pllc |
---|---|
Speciality | Dentist - General Practice |
Location | 2685 Channing Way, Idaho Falls, Idaho |
Authorized Official Name and Position | James G Drake (DOCTOR/PARTNER) |
Authorized Official Contact | 2085240870 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Grin Pllc 885 Pancheri Dr Idaho Falls ID 83402-3344 Ph: (208) 524-0870 | Grin Pllc 2685 Channing Way Idaho Falls ID 83404-7518 Ph: (208) 522-1164 |
NPI Number | 1144720103 |
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Provider Enumeration Date | 02/16/2018 |
Last Update Date | 02/16/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144720103 | NPI | - | NPPES |
000886878 | Other | UNITED CONCORDIA | |
001493204 | Other | UNITED CONCORDIA | |
6K158 | Other | ID | BLUE CROSS OF IDAHO |
6C016 | Other | ID | BLUE CROSS OF IDAHO |
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