| Darin R. Mooso | |
|
4105 Clock Tower Ave Caldwell ID 83607-5006 | |
| (208) 455-0033 | |
| (208) 455-8535 |
| Full Name | Darin R. Mooso |
|---|---|
| Speciality | Dentist |
| Location | 4105 Clock Tower Ave, Caldwell, Idaho |
| Authorized Official Name and Position | Darin R Mooso (PRESIDENT) |
| Authorized Official Contact | 2084550033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Darin R. Mooso 4105 Clock Tower Ave Caldwell ID 83607-5006 Ph: (208) 455-0033 | Darin R. Mooso 4105 Clock Tower Ave Caldwell ID 83607-5006 Ph: (208) 455-0033 |
| NPI Number | 1184160566 |
|---|---|
| Provider Enumeration Date | 01/10/2017 |
| Last Update Date | 01/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184160566 | NPI | - | NPPES |
| 9202299 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-3237 (Idaho) | Primary |
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