Individual
DR. BRENT DAVID POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5656 E LEBANON AVE, CLOVIS, CA 93619-9519
(216) 543-5178
Mailing address
5656 E LEBANON AVE, CLOVIS, CA 93619-9519
(216) 543-5178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
56148
CA
Other
Enumeration date
04/27/2008
Last updated
04/27/2008
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