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Organization
CLOCK TOWER DENTAL PA
Active
Organization
CLOCK TOWER DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARIN R MOOSO DDS (DENTIST)
(208) 455-9498
Entity
Organization
Contact information
Practice address
4105 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 455-9498
Mailing address
4105 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 455-9498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3237
ID
Other
Enumeration date
02/08/2007
Last updated
08/22/2020
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