Organization
PHILLIP W POWELL DDS
Active
Other names
Woodward Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP W POWELL DDS (OWNER)
(580) 256-2600
Entity
Organization
Contact information
Practice address
1222 MAIN AVE, WOODWARD, OK 73801
(580) 256-2600
(580) 256-2671
Mailing address
1222 MAIN AVE, WOODWARD, OK 73801
(580) 256-2600
(580) 256-2671
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4793
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100130660A
—
OK
Enumeration date
06/17/2008
Last updated
06/17/2008
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