| Grillz | |
|
4513 Enterprise Way Caldwell ID 83605 | |
| (208) 936-9244 | |
| Not Available |
| Full Name | Grillz |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4513 Enterprise Way, Caldwell, Idaho |
| Authorized Official Name and Position | Ryan Michael Leininger (GENERAL DENTIST) |
| Authorized Official Contact | 2089369244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grillz 4513 Enterprise Way Caldwell ID 83605 Ph: (208) 936-9244 | Grillz 4513 Enterprise Way Caldwell ID 83605 Ph: (208) 936-9244 |
| NPI Number | 1750044699 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 10/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750044699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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