Individual
DR. STANLEY SIMPSON GREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6726 W OVERLAND RD, BOISE, ID 83709-2032
(208) 375-0375
Mailing address
6726 W OVERLAND RD, BOISE, ID 83709-2032
(208) 375-0375
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1708
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69310
BLUE CROSS
ID
Enumeration date
08/03/2006
Last updated
07/08/2007
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