MEDICARE: DR. ROBERT FUCHS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2001007906	MO

General Provider Information

NPI Number	:	1568582419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT FUCHS D.D.S.

Provider Business Mailing Address
First Line	:	341 CASTLEGATE DR
Second Line	:
City	:	OZARK
State	:	MO
Zip	:	65721-7955
Country	:	US
Telephone Number	:	417-581-9532
Fax Number	:	206-666-6527

Provider Business Practice Location Address
First Line	:	1211 E BENNETT ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-1101
Country	:	US
Telephone Number	:	417-887-1841
Fax Number	:	206-666-6527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	07/08/2007

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