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Organization
POWELL AND MARTELLO P.C.
Active
Organization
POWELL AND MARTELLO P.C.
Active
Other names
oral surgery center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER THOMAS POWELL DDS (PRESIDENT)
(815) 464-6500
Entity
Organization
Contact information
Practice address
10241 W LINCOLN HWY, FRANKFORT, IL 60423-1279
(815) 464-6500
(815) 464-6503
Mailing address
10241 W LINCOLN HWY, FRANKFORT, IL 60423-1279
(815) 464-6500
(815) 464-6503
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021001487
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021001750
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021002201
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021002201
—
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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