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Individual

DR. R. STEVEN POWELL SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
625 RONALD REAGAN DR, EVANS, GA 30809-7602
(706) 860-6888
(706) 860-8202
Mailing address
625 RONALD REAGAN DR, EVANS, GA 30809-7602
(706) 860-6888
(706) 860-8202

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
009369
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009369
STATE DENTAL LICENSE
GA
Enumeration date
07/26/2006
Last updated
03/07/2023
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