# POWELL DENTAL PRACTICE, PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255471157
- **Authorized official:** DR. JASON WILLIAM POWELL D.D.S. (OWNER)
- **Authorized official phone:** (410) 695-5695

## Contact information

- **Practice address:** 3034 VALLEY AVE, SUITE 104, WINCHESTER, VA 22601-2670
- **Practice address phone:** (410) 695-5695
- **Mailing address:** 2020 BEALMEAR MILL LN, APT 6201, ODENTON, MD 21113-2996
- **Mailing address phone:** (410) 695-5695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401410627 | VA | Yes |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 01/20/2010