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General NPI Number Information
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NPI Number | 1033947882
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Entity Type | Individual
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Provider Name | JACKLYN ELIZABETH POWERS DMD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 361 WALKER DR STE 204
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City | WARRENTON
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State | VA
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Zip | 20186-4364
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Country | US
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Telephone | 540-341-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 7631 SWIFT XING
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City | WARRENTON
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State | VA
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Zip | 20187-4700
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Country | US
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Telephone | 540-878-1711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401419086
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License Number State | VA
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