Individual
DR. JACOB A POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535
(707) 423-7000
Mailing address
101 BODIN CIRCLE, TRAVIS AFB, CA 94535-1800
(707) 423-7000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D-4232
ID
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-4232
ID
Other
Enumeration date
06/24/2009
Last updated
05/14/2025
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