| Capitol Dental, Pc | |
|
314 W Bannock St Boise ID 83702-6032 | |
| (208) 336-9333 | |
| (208) 387-1951 |
| Full Name | Capitol Dental, Pc |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 314 W Bannock St, Boise, Idaho |
| Authorized Official Name and Position | Darrel L Mooney (OWNER) |
| Authorized Official Contact | 2083369333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capitol Dental, Pc 314 W Bannock St Boise ID 83702-6032 Ph: (208) 336-9333 | Capitol Dental, Pc 314 W Bannock St Boise ID 83702-6032 Ph: (208) 336-9333 |
| NPI Number | 1831101518 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831101518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
| 1223P0700X | Dentist - Prosthodontics | (* (Not Available)) | Primary |
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