Organization
DARREL AND ROSEANN MOONEY
Active
Other names
Idaho Prosthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREL LAVERNE MOONEY DDS (OWNWE)
(208) 841-5038
Entity
Organization
Contact information
Practice address
1323 MICHIGAN ST, SANDPOINT, ID 83864-1747
(208) 263-6393
Mailing address
347 CROOKED EAR CT, SANDPOINT, ID 83864-9477
(208) 841-5038
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
D1650PR
ID
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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