Individual
GREGORY S HOLBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1301 MAIN ST, SUITE 9, SALMON, ID 83467-4451
(208) 756-2899
(208) 756-4686
Mailing address
1301 MAIN ST, SUITE 9, SALMON, ID 83467-4451
(208) 756-2899
(208) 756-4686
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3250
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00087549
UNITED CONCORDIA
ID
01
—
006084
DELTA DENTAL
ID
01
—
6A135
BLUE CROSS OF IDAHO
ID
Enumeration date
07/17/2006
Last updated
07/08/2007
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