Individual
DR. AVERY C. POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1719 HEATHER HILL CRES, FLOSSMOOR, IL 60422-2041
(170) 822-8047
Mailing address
PO BOX 232, MATTESON, IL 60443-0232
(170) 822-8047
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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