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1215072798
ROBERT L FACKRELL
POCATELLO, ID
NPI
1215072798
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: ID D3134)
Enumeration Date
2007-02-21
Last Update Date
2015-01-13
Business Address
Dr. ROBERT L FACKRELL DDS
415 N 3RD AVE STE A
POCATELLO, ID 83201-6306
Phone number: 208-233-2355
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Mailing Address
Dr. ROBERT L FACKRELL DDS
415 N 3RD AVE STE A
POCATELLO, ID 83201-6306
Phone number: 208-233-2355
Copy
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