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Individual

JOSEPH CHANCE POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1086
FL
1223P0221X
Pediatric Dentistry
Primary
09693
NC
1223P0221X
Pediatric Dentistry
DN014976
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09693
DENTAL LICENSE
NC
01
DN014976
DENTAL LICENSE
GA
Enumeration date
07/02/2012
Last updated
03/19/2019
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