Individual
KIRA JEANNETTE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
20460 COUNTY ROAD 11 NW, BIG LAKE, MN 55309-4851
(763) 263-7100
(763) 263-7114
Mailing address
PO BOX 308, MONTICELLO, MN 55362-0308
(763) 263-7100
(763) 263-7100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14409
MN
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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