Healthcare Provider Details

I. General information

NPI: 1104207216
Provider Name (Legal Business Name): CARING SMILES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 06/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8744 W. FAIRVIEW AVE
BOISE ID
83704
US

IV. Provider business mailing address

8744 W FAIRVIEW AVE
BOISE ID
83704-8207
US

V. Phone/Fax

Practice location:
  • Phone: 208-893-5000
  • Fax: 208-322-3364
Mailing address:
  • Phone: 208-895-5000
  • Fax: 208-322-3364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT W. GRANT
Title or Position: OWNER
Credential: DMD
Phone: 208-893-5000