Individual
DR. GRANT SAMUEL KIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
341 W IOWA AVE, NAMPA, ID 83686-2856
(208) 467-7401
Mailing address
1003 W LOCUST LN, NAMPA, ID 83686-8446
(208) 880-9149
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5407
ID
Other
Enumeration date
03/17/2022
Last updated
06/15/2022
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