Individual
DR. ALYSSHA BONIQUE POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1747 US HIGHWAY 1 S, ST AUGUSTINE, FL 32084-4238
(904) 717-0291
Mailing address
15036 NORMANDY BLVD, JACKSONVILLE, FL 32234-2302
(904) 891-7080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN23553
FL
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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