Robert L. Fackrell DDS PA

NPI #1801225180 in Pocatello, Idaho

Provider Information

NPI Number: 1801225180
Entity Type: Organization
Organization Name: Robert L. Fackrell DDS PA
Primary Specialty: Dentist
Enumeration Date: Nov 6, 2013
Last Updated: Jan 13, 2015

Practice Location

Address: 415 N 3RD AVE STE A
City: Pocatello
State: Idaho
ZIP Code: 83201-6306
Phone: (208) 233-2355

Authorized Official

Name: DR. ROBERT L FACKRELL, DDS
Title: PRESIDENT
Phone: (208) 233-2355

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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