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1992917207
CHARLES SCOTT GRACE
BOISE, ID
NPI
1992917207
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: ID D3522)
Enumeration Date
2007-05-07
Last Update Date
2010-08-02
Business Address
-- CHARLES SCOTT GRACE D.D.S
850 S LATAH ST
BOISE, ID 83705-2255
Phone number: 208-342-7714
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Mailing Address
-- CHARLES SCOTT GRACE D.D.S
850 S LATAH ST
BOISE, ID 83705-2255
Phone number: 208-342-7714
Copy
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