Provider Demographics
NPI:1902925126
Name:GANIR, ARIES J (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARIES
Middle Name:J
Last Name:GANIR
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 1:1064 W. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:ID
Mailing Address - Zip Code:83644
Mailing Address - Country:US
Mailing Address - Phone:208-585-9200
Mailing Address - Fax:
Practice Address - Street 1:1064 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644
Practice Address - Country:US
Practice Address - Phone:208-585-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-3574122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist