| Dental Depot | |
|
803 S Jefferson St Suite 2 Moscow ID 83843-3096 | |
| (208) 882-2531 | |
| (208) 882-5701 |
| Full Name | Dental Depot |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 803 S Jefferson St, Moscow, Idaho |
| Authorized Official Name and Position | Jesse Cole (PARTNER) |
| Authorized Official Contact | 2088822531 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Depot 803 S Jefferson St Suite 2 Moscow ID 83843-3096 Ph: (208) 882-2531 | Dental Depot 803 S Jefferson St Suite 2 Moscow ID 83843-3096 Ph: (208) 882-2531 |
| NPI Number | 1023225638 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023225638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3990 (Idaho) | Primary |
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