ROBERT L FACKRELL

POCATELLO, ID
NPI1215072798
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: ID  D3134)
Enumeration Date2007-02-21
Last Update Date2015-01-13
Business Address
Dr. ROBERT L FACKRELL DDS
415 N 3RD AVE STE A
POCATELLO, ID 83201-6306
Phone number: 208-233-2355
Mailing Address
Dr. ROBERT L FACKRELL DDS
415 N 3RD AVE STE A
POCATELLO, ID 83201-6306
Phone number: 208-233-2355