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General NPI Number Information
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NPI Number | 1215960349
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Entity Type | Organization
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Legal Business Name | CLOCKWORKS DENTAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 01/02/2013
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Provider Practice Location Address
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Address Line | 1590 MEDICAL DR SUITE D
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City | POTTSTOWN
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State | PA
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Zip | 19464-3247
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Country | US
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Telephone | 610-323-6520
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Fax | 610-327-0521
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Provider Business Mailing Address
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Address Line | 1590 MEDICAL DR SUITE D
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City | POTTSTOWN
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State | PA
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Zip | 19464-3247
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Country | US
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Telephone | 610-323-6520
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Fax | 610-327-0521
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN P POWELL
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Credential | D.M.D
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Telephone | 610-323-6520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS028301L
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License Number State | PA
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