| Ethan D Moulton, DDS,MS | |
|
2375 E Sunnyside Rd Ste I, Idaho Falls, ID 83404-8281 | |
| (208) 522-6683 | |
| (208) 552-3085 |
| Full Name | Ethan D Moulton |
|---|---|
| Gender | Male |
| Speciality | Dentist - Periodontics |
| Location | 2375 E Sunnyside Rd Ste I, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740222579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5588 (Oklahoma) | Secondary |
| 1223P0300X | Dentist - Periodontics | D-4093-PE (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan D Moulton, DDS,MS 2375 E Sunnyside Rd Ste I, Idaho Falls, ID 83404-8281 Ph: (208) 522-6683 | Ethan D Moulton, DDS,MS 2375 E Sunnyside Rd Ste I, Idaho Falls, ID 83404-8281 Ph: (208) 522-6683 |
Dr. Christopher M Cannon, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 3550 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-524-2300 Fax: 208-545-8447 | |
Dr. Ryan T Kidman, DDS Dentist Medicare: Medicare Enrolled Practice Location: 139 Alturas St, Idaho Falls, ID 83401 Phone: 208-523-5090 Fax: 208-895-0583 | |
Dr. Dwight Douglas Baker, D.D.S., M.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1900 John Adams Pkwy, Idaho Falls, ID 83401 Phone: 208-524-0644 Fax: 208-524-6100 | |
Mark Asael Tall, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2460 E 25th St, Idaho Falls, ID 83404 Phone: 208-525-4780 Fax: 508-525-4785 | |
Dr. Ron D Sheppard, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2300 E 17th St, Idaho Falls, ID 83404 Phone: 208-525-8383 Fax: 208-523-6419 | |
Dr. Trent Charles Buehler, DMD Dentist Medicare: Medicare Enrolled Practice Location: 2860 Valencia Dr Ste 100, Idaho Falls, ID 83404 Phone: 855-433-6825 | |
Dr. Philip R Harper, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 3550 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-524-2300 Fax: 208-545-8447 |