Organization
DARIN R. MOOSO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARIN R MOOSO DDS (PRESIDENT)
(208) 455-0033
Entity
Organization
Contact information
Practice address
4105 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 455-0033
(208) 455-8535
Mailing address
4105 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 455-0033
(208) 455-8535
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-3237
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9202299
—
ID
Enumeration date
01/10/2017
Last updated
01/10/2017
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