Organization
POWELL DENTAL PRACTICE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON WILLIAM POWELL D.D.S. (OWNER)
(410) 695-5695
Entity
Organization
Contact information
Practice address
3034 VALLEY AVE, SUITE 104, WINCHESTER, VA 22601-2670
(410) 695-5695
Mailing address
2020 BEALMEAR MILL LN, APT 6201, ODENTON, MD 21113-2996
(410) 695-5695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410627
VA
Other
Enumeration date
02/08/2007
Last updated
01/20/2010
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