Healthcare Provider Details

I. General information

NPI: 1861502213
Provider Name (Legal Business Name): GRANT FRANCIS DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

943 N LINDER AVE STE 101
KUNA ID
83634-3395
US

IV. Provider business mailing address

943 N LINDER AVE STE 101
KUNA ID
83634-3395
US

V. Phone/Fax

Practice location:
  • Phone: 208-922-1919
  • Fax: 208-922-3567
Mailing address:
  • Phone: 208-922-1919
  • Fax: 208-922-3567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD3390
License Number StateID

VIII. Authorized Official

Name: DR. GRANT H FRANCIS
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 208-922-1919