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General NPI Number Information
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NPI Number | 1104207216
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Entity Type | Organization
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Legal Business Name | CARING SMILES PLLC
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 8744 W. FAIRVIEW AVE
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City | BOISE
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State | ID
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Zip | 83704
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Country | US
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Telephone | 208-893-5000
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Fax | 208-322-3364
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Provider Business Mailing Address
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Address Line | 8744 W FAIRVIEW AVE
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City | BOISE
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State | ID
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Zip | 83704-8207
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Country | US
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Telephone | 208-895-5000
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Fax | 208-322-3364
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT W. GRANT
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Credential | DMD
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Telephone | 208-893-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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