Provider Demographics
NPI:1356193999
Name:FOXCROFT, WILLIAM DRAYSON
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DRAYSON
Last Name:FOXCROFT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13288 W SATINLEAF DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1992
Mailing Address - Country:US
Mailing Address - Phone:408-833-3173
Mailing Address - Fax:
Practice Address - Street 1:4274 N EAGLE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-0726
Practice Address - Country:US
Practice Address - Phone:408-833-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-5621122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist