Individual
DR. GORDON G CROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
8300 NORTHVIEW ST, BOISE, ID 83704-7132
(208) 377-8078
(208) 377-3689
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 467-4431
(208) 467-3391
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1518
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000789200
—
ID
01
—
462879
UNITED CONCORDIA
ID
01
—
6C396
BLUE CROSS
ID
Enumeration date
02/26/2008
Last updated
04/23/2018
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