| NPI | 1902490840 |
|---|---|
| Doing Business As | POWELL VALLEY DENTAL |
| Entity Type | Organization |
| Authorized Contact | SAMANTHA ALLRED Secretary 760-807-6632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-08-05 |