Individual
DR. GREGORY GRANT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
205 N BERKLEY ST, COUNCIL, ID 83612-5015
(208) 253-4242
Mailing address
PO BOX 1268, MCCALL, ID 83638-1268
(714) 552-1562
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
45619
CA
1223G0001X
General Practice Dentistry
Primary
D-5262
ID
Other
Enumeration date
06/27/2005
Last updated
09/23/2021
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