Individual
DR. KENT E MOSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
910 W IRONWOOD DR, COEUR D'ALENE, ID 83814
(208) 667-1154
(208) 667-9024
Mailing address
910 W IRONWOOD DR., COEUR D'ALENE, ID 83814
(208) 667-1154
(208) 667-9024
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3671
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6J770
BLUE CROSS OF IDAHO
ID
Enumeration date
09/15/2006
Last updated
12/06/2011
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