Individual
EASTON GRANT ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1720 W MCMILLAN RD, MERIDIAN, ID 83646-6892
(208) 216-1718
Mailing address
1720 W MCMILLAN RD, MERIDIAN, ID 83646-6892
(208) 216-1718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9981910
ID
Other
Enumeration date
07/16/2026
Last updated
07/16/2026
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