Organization
K S POWELL DDS PC
Active
Other names
The Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH SENIOR POWELL II DDS (PRESIDENT)
(314) 381-1556
Entity
Organization
Contact information
Practice address
3403 UNION BLVD, SAINT LOUIS, MO 63115-1127
(314) 381-1556
(314) 381-4559
Mailing address
3403 UNION BLVD, SAINT LOUIS, MO 63115-1127
(314) 381-1556
(314) 381-4559
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011987
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11987
DENTAL LICENSE
MO
Enumeration date
11/07/2006
Last updated
08/22/2020
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