Fackrell Family Dentistry

LBN: Robert L. Fackrell Dds Pa
Fackrell Family Dentistry is an health care organization with primary practice located at 415 N 3Rd Ave Ste A , Pocatello ID 83201-6306. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Robert L. Fackrell Dds Pa can be contacted via phone (208) 233-2355, or through Fackrell, Robert L via phone (208) 233-2355.

Contact Information

Primary practice address
415 N 3Rd Ave Ste A Pocatello ID 83201-6306
Phone: (208) 233-2355
Fax: (208) 233-0582
Website:
Map and Directions
Authorized official contact:
Name: Fackrell, Robert L Doctor of Dental Surgery (DDS)
Phone: (208) 233-2355

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D3134 Idaho

Profile Details

NPI number 1801225180
LBN Legal business name Robert L. Fackrell Dds Pa
DBA Doing business as Fackrell Family Dentistry
Authorized official Fackrell, Robert L Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2013
Last updated Jan 13th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801225180 NPPES
Idaho MEDICAID 1215072798

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