CLOCK TOWER DENTAL PA NPI 1720128432

NPI Information

CLOCK TOWER DENTAL PA is a general practice dentist in Caldwell, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CLOCK TOWER DENTAL PA NPI is 1720128432. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4105 CLOCK TOWER AVE
CALDWELL, ID
ZIP 83607-006
Phone: (208) 455-9498

The provider's authorized official is Darin R Mooso .
The authorized official title is Dentist and has the following contact phone number (208) 455-9498.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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