Provider Demographics
NPI:1740410885
Name:FAUCHER, ROBERT R (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:FAUCHER
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21701 76TH AVE W
Mailing Address - Street 2:STE 204
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21701 76TH AVE W
Practice Address - Street 2:STE 204
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7536
Practice Address - Country:US
Practice Address - Phone:425-775-1045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA45741223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics