Grin Pllc
NPI #1144720103 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1144720103
- Entity Type
- Organization
- Organization Name
- Grin Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 16, 2018
- Last Updated
- Feb 16, 2018
Practice Location
- Address
- 2685 CHANNING WAY
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-7518
- Phone
- (208) 522-1164
Authorized Official
- Name
- DR. JAMES G DRAKE, DMD
- Title
- DOCTOR/PARTNER
- Phone
- (208) 524-0870
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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