Individual
DR. MATTHEW FORREST POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1036 BRIGHTON AVE STE A, PORTLAND, ME 04102-1049
(207) 773-2150
Mailing address
1036 BRIGHTON AVE STE A, PORTLAND, ME 04102-1049
(207) 773-2150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN4910
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04671
DENTAL LICENSE NUMBER
NH
Enumeration date
08/13/2021
Last updated
09/01/2021
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