# POWELL AND MARTELLO P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** oral surgery center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518191295
- **Authorized official:** DR. CHRISTOPHER THOMAS POWELL DDS (PRESIDENT)
- **Authorized official phone:** (815) 464-6500

## Contact information

- **Practice address:** 10241 W LINCOLN HWY, FRANKFORT, IL 60423-1279
- **Practice address phone:** (815) 464-6500
- **Practice address fax:** (815) 464-6503
- **Mailing address:** 10241 W LINCOLN HWY, FRANKFORT, IL 60423-1279
- **Mailing address phone:** (815) 464-6500
- **Mailing address fax:** (815) 464-6503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 021001487 | IL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 021001750 | IL | Yes |
| 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