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Dr. Brett Eddis Mooso, DDS,MS,PA
Orthodontics and Dentofacial Orthopedic Dentist in Idaho Falls, Idaho
NPI 1902902208

Brett Eddis Mooso is a Orthodontics and Dentofacial Orthopedic Dentist based in Idaho Falls, ID and is specialized in Orthodontics and Dentofacial Orthopedics. Brett Eddis Mooso practices in Idaho Falls, ID and has the professional credentials of DDS,MS,PA. The NPI Number for Brett Eddis Mooso is 1902902208 and holds a License No. D-3029-OR (Idaho).

The current practice location address for Brett Eddis Mooso is 1410 E 17Th St, Idaho Falls, ID and can be reached out via phone at 208-522-4552 and via fax at 208-522-4555.

Location: 1410 E 17Th St, Idaho Falls, ID, 83404-6269
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902902208
Provider Name
Brett Eddis Mooso
Credential
DDS,MS,PA
Provider Entity Type
Individual
Gender
Male
Address
1410 E 17Th St, Idaho Falls, ID, 83404-6269
Phone Number
208-522-4552
Fax Number
208-522-4555
Provider Enumeration Date
09/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6083 01 ID BLUE CROSS PROVIDER NUMBE
000010012359 01 ID BLUE SHIELD PROVIDE NUMBE
institution
Provider Business Practice Location Address Details
Address
1410 E 17Th St
City
Idaho Falls
State
Idaho
Zip
83404-6269
Phone Number
208-522-4552
Fax Number
208-522-4555
person
Provider Business Mailing Address Details
Address
1410 E 17Th St
City
Idaho Falls
State
Idaho
Zip
83404-6269
Phone Number
208-522-4552
Fax Number
208-522-4555
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Orthodontics and Dentofacial Orthopedics
Taxonomy
1223X0400X
License No.
D-3029-OR (Idaho)
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
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