Provider Demographics
NPI:1447872361
Name:GARNER, GARRETT FOSTER (DMD)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:FOSTER
Last Name:GARNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 N MERRITT CREEK LOOP
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2950
Mailing Address - Country:US
Mailing Address - Phone:208-676-8500
Mailing Address - Fax:208-246-2400
Practice Address - Street 1:2344 N MERRITT CREEK
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2950
Practice Address - Country:US
Practice Address - Phone:208-676-8500
Practice Address - Fax:208-246-2400
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61084821122300000X
IDD-5506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist