Individual provider · Type 1 NPI

Domenick Fuller, DDS

General Practice Dentistry · Pocatello, ID

NPI number 1649063850 Active

Practice location

921 S 8th Ave
Pocatello, ID 83209-0002

Call (208) 282-3289 Map

Mailing address

397 E Shepard Ln
Kaysville, UT 84037-9637

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X9271560 (ID)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1649063850

Domenick Fuller, DDS's National Provider Identifier is 1649063850, issued on May 28, 2025. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Pocatello, ID. The record was last updated on Jun 4, 2025.