| Clock Tower Dental Pa | |
|
4105 Clock Tower Ave Caldwell ID 83607-5006 | |
| (208) 455-9498 | |
| Not Available |
| Full Name | Clock Tower Dental Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4105 Clock Tower Ave, Caldwell, Idaho |
| Authorized Official Name and Position | Darin R Mooso (DENTIST) |
| Authorized Official Contact | 2084559498 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clock Tower Dental Pa 4105 Clock Tower Ave Caldwell ID 83607-5006 Ph: (208) 455-9498 | Clock Tower Dental Pa 4105 Clock Tower Ave Caldwell ID 83607-5006 Ph: (208) 455-9498 |
| NPI Number | 1720128432 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720128432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3237 (Idaho) | Primary |
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