| NPI | 1124330592 |
|---|---|
| Former Name | JULIE JO POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 6242) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D8013) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2011-09-26 |