Individual
DR. KIMBERLY NICOLE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6028
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6028
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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