SearchIdaho1223G0001X

Domenick Fuller, DDS

NPI 1649063850 · on the registry since 2025

Practice

Address
921 S 8th Ave
Pocatello, ID 83209
Phone
(208) 282-3289
Organisation at this address
Idaho State University
Inferred from a shared address, not stated in the registry.
Clinicians at this address
39

Registry record

Primary taxonomy
1223G0001X
1223G0001X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-06-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho