Clock Tower Dental PA

NPI #1720128432 in Caldwell, Idaho

Provider Information

NPI Number: 1720128432
Entity Type: Organization
Organization Name: Clock Tower Dental PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 8, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 4105 CLOCK TOWER AVE
City: Caldwell
State: Idaho
ZIP Code: 83607-5006
Phone: (208) 455-9498

Authorized Official

Name: DR. DARIN R MOOSO, DDS
Title: DENTIST
Phone: (208) 455-9498

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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