IndividualActive
Brett Mooso, D.D.S.,M.S.,P.A.
NPI 1902902208 · Orthodontics and Dentofacial Orthopedics Dentistry · Idaho Falls, ID
Provider details
- NPI number
- 1902902208
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- D.D.S.,M.S.,P.A.
- Sex
- Male
- Sole proprietor
- Yes
- License
- D-3029-OR (ID)
Specialties & taxonomies
Dental Providers
Practice location
1410 E 17th St
Idaho Falls, ID 83404-6269
Phone: (208) 522-4552
Fax: (208) 522-4555
Approximate (ZIP-level) locationGet directions
Mailing address
1410 E 17th St
Idaho Falls, ID 83404-6269
Registry dates
- Enumerated
- 2006-09-15
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.