Provider Demographics
NPI:1861805947
Name:FECHNER, ROBERT (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:FECHNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1127
Mailing Address - Country:US
Mailing Address - Phone:636-236-8561
Mailing Address - Fax:
Practice Address - Street 1:5754 ANTIOCH RD
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66202-2015
Practice Address - Country:US
Practice Address - Phone:913-671-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014016796122300000X
KS61013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist