| NPI | 1013312289 |
|---|---|
| Doing Business As | POWELL PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BRENT DAVID POWELL Owner 558-299-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 56148) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2014-10-29 |