Individual
GREGORY JOE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
12255 DE PAUL DR., STE 885, BRIDGETON, MO 63044
(314) 298-0727
(314) 298-9151
Mailing address
12255 DE PAUL DR., STE 885, BRIDGETON, MO 63044
(314) 298-0727
(314) 298-9151
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
012148
MO
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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