Individual
KIPLEY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4716 W URBANA ST, BROKEN ARROW, OK 74012-6162
(918) 449-5800
Mailing address
4716 W URBANA ST, BROKEN ARROW, OK 74012-6162
(918) 449-5800
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
246
OK
Other
Enumeration date
06/04/2020
Last updated
06/28/2024
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