Individual
DR. JOHN T MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
333 WEST CEDAR, POCATELLO, ID 83201-0000
(208) 233-6912
(208) 233-6921
Mailing address
2645 SUMMERS WAY, POCATELLO, ID 83204-0000
(208) 233-8015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1486
ID
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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